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Adult Nephrolithiasis Case Study: Implications for the Urology Industry
By Dr. Eleanor Vance, MD, Associate Professor of Urology, University of California, San Francisco
Published by: The Journal of Urological Sciences, a leading peer-reviewed publication renowned for its rigorous editorial process and impact within the urology and nephrology communities.
Editor: Dr. Mark Johnson, MD, PhD, former President of the American Urological Association, with over 30 years of experience in urological research and clinical practice.
Abstract: This adult nephrolithiasis case study examines the complex presentation, diagnosis, and management of a 45-year-old male patient with recurrent calcium oxalate nephrolithiasis. The case highlights the challenges in identifying predisposing factors, the importance of comprehensive metabolic evaluation, and the evolving landscape of treatment options, including minimally invasive surgical techniques. This case study provides valuable insights into the impact of nephrolithiasis on healthcare systems and underscores the need for improved preventative strategies and personalized treatment approaches.
Keywords: adult nephrolithiasis case study, kidney stones, nephrolithiasis treatment, calcium oxalate stones, urolithiasis, minimally invasive surgery, metabolic evaluation, healthcare costs, patient management
Introduction: Understanding the Burden of Adult Nephrolithiasis
Adult nephrolithiasis, commonly known as kidney stones, represents a significant public health problem with escalating prevalence worldwide. This adult nephrolithiasis case study focuses on a specific patient encounter to illustrate the complexities involved in managing this condition. The economic burden associated with diagnosis, treatment, and long-term management is substantial, impacting healthcare systems globally. Therefore, a thorough understanding of risk factors, diagnostic approaches, and treatment modalities is crucial for optimizing patient care and reducing healthcare costs.
Case Presentation: A Recurring Challenge
Mr. A, a 45-year-old male, presented to the urology clinic with acute right flank pain, radiating to the groin, accompanied by nausea and hematuria. He reported a history of similar episodes in the past, having undergone ureteroscopy and stone removal two years prior. His medical history was significant for hypertension and a family history of nephrolithiasis. Initial laboratory investigations revealed elevated serum creatinine (1.3 mg/dL) and microhematuria. A non-contrast computed tomography (CT) scan of the abdomen and pelvis confirmed a 7 mm calcium oxalate stone obstructing the right ureteropelvic junction. This adult nephrolithiasis case study clearly demonstrates a recurrent condition highlighting the importance of preventative care.
Diagnostic Evaluation: Unraveling the Underlying Causes
Beyond identifying the stone itself, a crucial aspect of managing adult nephrolithiasis is to determine the underlying metabolic and dietary factors contributing to stone formation. A comprehensive metabolic evaluation was initiated for Mr. A, including a 24-hour urine collection to assess for hypercalciuria, hyperuricosuria, and other metabolic abnormalities. This evaluation is critical in guiding long-term preventative strategies. Detailed dietary history, including fluid intake and dietary calcium and oxalate levels, were also reviewed.
Treatment Strategies: Minimally Invasive Approaches
Given Mr. A's history of recurrent stones and the location of the current stone, a minimally invasive approach was chosen. Ureteroscopy with laser lithotripsy was performed successfully, removing the 7 mm stone. This adult nephrolithiasis case study illustrates the effectiveness of this method for many patients. Post-operative recovery was uneventful.
Long-Term Management and Prevention
Following successful stone removal, Mr. A was counseled on lifestyle modifications, including increased fluid intake (at least 2-3 liters per day), dietary changes to reduce oxalate intake, and the importance of regular follow-up. The results of his metabolic evaluation revealed mild hypercalciuria. Therefore, a tailored preventative regimen, including thiazide diuretics to manage his hypercalciuria, was implemented. This adult nephrolithiasis case study demonstrates how personalized management, factoring in individual patient characteristics and metabolic profiles, leads to improved outcomes.
Implications for the Urology Industry: Improving Patient Care and Reducing Costs
This adult nephrolithiasis case study highlights several key implications for the urology industry:
The need for improved diagnostic tools: Early and accurate identification of stone composition and metabolic risk factors is crucial for personalized treatment and prevention. Advanced imaging techniques and sophisticated metabolic testing play a vital role.
Minimally invasive surgical techniques: These methods offer significant advantages over open surgery, including reduced hospital stay, faster recovery time, and lower complication rates. Further advancements in these techniques continue to improve patient outcomes.
The importance of preventative strategies: Lifestyle modifications, tailored dietary advice, and pharmacological interventions are essential for reducing the recurrence rate of nephrolithiasis.
The economic burden: The high prevalence and recurrent nature of nephrolithiasis place a substantial burden on healthcare systems. Developing cost-effective preventative strategies and optimizing treatment algorithms are crucial. This adult nephrolithiasis case study underscores the need for proactive measures to mitigate this burden.
Conclusion
This adult nephrolithiasis case study underscores the complexity of managing this prevalent condition. A multi-faceted approach encompassing accurate diagnosis, minimally invasive treatment, and comprehensive long-term management is crucial for optimizing patient outcomes and minimizing the economic burden on healthcare systems. Further research into the underlying causes and improved preventative strategies remains a critical area for future investigation. The ongoing evolution of treatment techniques and a deeper understanding of individual patient factors are essential for improving the lives of those affected by nephrolithiasis.
FAQs
1. What are the common symptoms of kidney stones? Common symptoms include severe flank pain, radiating to the groin, nausea, vomiting, hematuria (blood in the urine), and urinary urgency or frequency.
2. How are kidney stones diagnosed? Kidney stones are typically diagnosed using imaging techniques like ultrasound, CT scans, or KUB (kidney, ureter, bladder) x-rays.
3. What are the different types of kidney stones? Common types include calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones.
4. What are the treatment options for kidney stones? Treatment options vary depending on the size and location of the stone and may include watchful waiting, medications to help pass the stone, extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or open surgery.
5. How can I prevent kidney stones? Prevention strategies include increased fluid intake, dietary modifications (reducing oxalate and sodium intake), and in some cases, medication.
6. What is the role of metabolic evaluation in kidney stone management? Metabolic evaluation helps identify underlying metabolic abnormalities contributing to stone formation, allowing for targeted preventative measures.
7. Are there genetic factors involved in kidney stone formation? Yes, a family history of kidney stones increases the risk of developing stones.
8. What is the long-term prognosis for patients with kidney stones? The long-term prognosis is generally good, especially with appropriate management and lifestyle modifications to prevent recurrence.
9. How common are kidney stones? Kidney stones affect approximately 10% of people in their lifetime.
Related Articles:
1. "The Impact of Obesity on Adult Nephrolithiasis: A Systematic Review": This article explores the correlation between obesity and the increased risk of developing kidney stones.
2. "Minimally Invasive Surgical Techniques in the Management of Adult Nephrolithiasis: A Comparative Analysis": This paper compares the efficacy and safety of different minimally invasive procedures used to treat kidney stones.
3. "Metabolic Evaluation in Adult Nephrolithiasis: A Practical Approach": This article provides a practical guide on conducting and interpreting metabolic evaluations for patients with kidney stones.
4. "Long-Term Outcomes and Recurrence Rates Following Ureteroscopy for Nephrolithiasis": This study investigates the long-term success rates and recurrence rates after ureteroscopy for kidney stone removal.
5. "The Role of Dietary Interventions in Preventing Recurrent Nephrolithiasis": This article discusses the importance of dietary modifications in preventing the recurrence of kidney stones.
6. "Pharmacological Management of Hypercalciuria in Adult Nephrolithiasis": This article focuses on the different medications used to manage hypercalciuria, a common metabolic abnormality associated with kidney stones.
7. "Cost-Effectiveness Analysis of Different Treatment Modalities for Nephrolithiasis": This study compares the cost-effectiveness of various treatment strategies for kidney stones.
8. "The Psychological Impact of Recurrent Nephrolithiasis on Patients' Quality of Life": This article examines the effect of recurrent kidney stones on patients' mental health and overall well-being.
9. "Advances in Imaging Techniques for the Diagnosis and Management of Nephrolithiasis": This paper reviews the latest advancements in imaging technologies used to diagnose and manage kidney stones.
| adult nephrolithiasis case study: Smith and Tanagho's General Urology, 19th Edition Jack W. McAninch, Tom F. Lue, 2020-03-27 The definitive guide to understanding, diagnosing, and treating urologic disorders – now in full color for the first time! A Doody's Core Title for 2023! Smith & Tanagho’s General Urology, Nineteenth Edition offers a complete overview of the diagnosis and treatment of the diseases and disorders managed by urologic surgeons. This trusted classic delivers a clear, concise presentation of the etiology, pathogenesis, clinical findings, differential diagnosis, and medical and surgical treatment of all major urologic conditions. The well-organized, user-friendly design makes relevant clinical information and management guidelines easy to find and simple to implement. NEW full-color presentation High-yield descriptions of the latest diagnostic modalities and management protocols More than 1,000 illustrations and figures, including CT scans, radionuclide imaging scans, and x-rays NEW chapters on female urology and pediatric urology Ideal for residents and medical students who require a concise and comprehensive reference Great for board preparation |
| adult nephrolithiasis case study: Dietary Reference Intakes Institute of Medicine, Food and Nutrition Board, 1999-04-07 The model for risk assessment of nutrients used to develop tolerable upper intake levels (ULs) is one of the key elements of the developing framework for Dietary Reference Intakes (DRIs). DRIs are dietary reference values for the intake of nutrients and food components by Americans and Canadians. The U.S. National Academy of Sciences recently released two reports in the series (IOM, 1997, 1998). The overall project is a comprehensive effort undertaken by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (DRI Committee) of the Food and Nutrition Board (FNB), Institute of Medicine, National Academy of Sciences in the United States, with active involvement of Health Canada. The DRI project is the result of significant discussion from 1991 to 1996 by the FNB regarding how to approach the growing concern that one set of quantitative estimates of recommended intakes, the Recommended Dietary Allowances (RDAs), was scientifically inappropriate to be used as the basis for many of the uses to which it had come to be applied. |
| adult nephrolithiasis case study: Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids Institute of Medicine, Food and Nutrition Board, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Subcommittee on Interpretation and Uses of Dietary Reference Intakes, Subcommittee on Upper Reference Levels of Nutrients, Panel on Dietary Antioxidants and Related Compounds, 2000-08-27 This volume is the newest release in the authoritative series of quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. Dietary Reference Intakes (DRIs) is the newest framework for an expanded approach developed by U.S. and Canadian scientists. This book discusses in detail the role of vitamin C, vitamin E, selenium, and the carotenoids in human physiology and health. For each nutrient the committee presents what is known about how it functions in the human body, which factors may affect how it works, and how the nutrient may be related to chronic disease. Dietary Reference Intakes provides reference intakes, such as Recommended Dietary Allowances (RDAs), for use in planning nutritionally adequate diets for different groups based on age and gender, along with a new reference intake, the Tolerable Upper Intake Level (UL), designed to assist an individual in knowing how much is too much of a nutrient. |
| adult nephrolithiasis case study: Oxford Textbook of Clinical Nephrology Neil N. Turner, Norbert Lameire, David J. Goldsmith, Christopher G. Winearls, Jonathan Himmelfarb, Giuseppe Remuzzi, 2015-10-29 This fourth edition of the Oxford Textbook of Clinical Nephrology builds on the success and international reputation of the publication as an important resource for the practising clinician in the field. It provides practical, scholarly, and evidence-based coverage of the full spectrum of clinical nephrology, written by a global faculty of experts. The most relevant and important reference to clinical nephrology, this is an authoritative and comprehensive textbook combining the clinical aspects of renal disease essential to daily clinical practice with extensive information about the underlying basic science and current evidence available. Each section of the textbook has been critically and comprehensively edited under the auspices of a leading expert in the field. This new edition has been significantly expanded and reapportioned to reflect developments and new approaches to topics, and includes treatment algorithms to aid and enhance patient care where possible. The fourth edition offers increased focus on the medical aspects of transplantation, HIV-associated renal disease, and infection and renal disease, alongside entirely new sections on genetic topics and clinical and physiological aspects of fluid/electrolyte and tubular disorders. The emphasis throughout is on marrying advances in scientific research with clinical management. Richly illustrated throughout in full colour, this is a truly modern and attractive edition which reinforces the Oxford Textbook of Clinical Nephrology's position as an indispensable reference work of consistent quality and reliability. Enriched and refined by careful revision, this new edition continues the tradition of excellence. This print edition of The Oxford Textbook of Clinical Nephrology comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables. Oxford Medicine Online is mobile optimized for access when and where you need it. |
| adult nephrolithiasis case study: Treatment of Urolithiasis M. Akimoto, E. Higashihara, H. Kumon, Z. Masaki, S. Orikasa, 2012-12-06 Urolithiasis is not only one of the most frequently encountered diseases at uro logical clinics; it is also the disorder whose treatment has shown the most rapid progress in the past decade. In that period, medicine has experienced a real revolution, characterized by minimally invasive treatments, improvement of the quality of life, and cost-effectiveness in treatment outcomes. In urology, the revolution started with the development of endoscopic retrograde treatment of urolithiasis in the upper urinary tract, which led to development of the percuta neous antegrade maneuver in the latter half of the 1970s. The most remarkable event occurred in 1982, when clinical use of extracorporeal shock wave lithotripsy was introduced by the Munich group, represented by Dr. Christian Chaussy, at the 18th Congress of the International Society of Urology in San Francisco. With the advent of these new strategies, open surgery for urolithiasis has all but dis appeared. Today, with the availability of new technology and equipment, guide lines for the treatment of urolithiasis have changed in all developed countries. It is quite timely that the Meeting of International Consultation on Urolithiasis will be held in Paris in June 2001 to establish international guidelines for urolithiasis. Looking through this textbook for urolithiasis, I was greatly impressed to learn that we have already drawn up some guidelines. The book includes all the updated advances of urolithiasis presented by the most prominent and experi enced urologists from all around the world. |
| adult nephrolithiasis case study: 50 Studies Every Urologist Should Know Philipp Dahm, 2021-02-26 50 Studies Every Urologist Should Know presents key studies that have shaped the practice of urology. Selected using a rigorous methodology, the studies cover topics including reflux disease in paediatric urology, management of male erectile dysfunction and lower urinary tract symptoms, female urology and stone disease, the various forms of genitourinary cancer, and more. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for healthcare professionals in urology, as well as anyone who wants to learn more about the data behind clinical practice. |
| adult nephrolithiasis case study: Nutritional and Medical Management of Kidney Stones Haewook Han, Walter P. Mutter, Samer Nasser, 2019-07-12 This text comprehensively covers the nutritional and medical management and prevention of kidney stones. Sections address types of stones, nutritional risks, medical and pharmaceutical managements, prevention of recurrence, and special consideration of stone risks among specific diseases such as obesity with gastric bypass, chronic kidney disease, and gastric intestinal disorders. Diagnosis of kidney stones, urinalysis and biochemical indices, dietary assessment, and medical nutrition therapy for specific types of kidney stones are also included. In addition, case studies are provided in the appendix. Cutting edge research is also highlighted in regards to pharmaceutical treatments and epidemiological findings in nutrition and kidney stones. Nutrition in Medical Management of Kidney Stones will be a practical resource for health professionals in the fields of nutrition, nephrology, urology, and general medicine, as well as medical students, resident physicians, and allied health clinicians whose research, practice, and education includes nutrition and kidney stones. |
| adult nephrolithiasis case study: Symptom to Diagnosis Scott D. C. Stern, Adam S. Cifu, Diane Altkorn, 2006 This innovative introduction to patient encounters utilizes an evidence-based step-by-step process that teaches students how to evaluate, diagnose, and treat patients based on the clinical complaints they present. By applying this approach, students are able to make appropriate judgments about specific diseases and prescribe the most effective therapy. (Product description). |
| adult nephrolithiasis case study: Nutrition in Kidney Disease Laura D. Byham-Gray, Jerrilynn D. Burrowes, Glenn M. Chertow, 2014-01-23 Nutrition in Kidney Disease, Second Edition addresses the relationships between nutrition and (1) normal kidney function and disease, (2) the progressiveness of chronic kidney disease (CKD) and strategies to prevent further compromise, and (3) the treatment and management of kidney failure especially during medical crises, such as acute kidney injury and its consequent nutritional therapies (e.g., enteral and parenteral nutrition). Demographic patterns, trends and outcomes in the current health care systems are explored in the United States and abroad. Disease prevention and management are presented over the entire lifespan, beginning with pregnancy, followed by infancy, childhood, adolescence, and adulthood, concluding with the elder years. Foundations for clinical practice are established by devoting a complete section towards conducting a comprehensive nutritional assessment, comprising of anthropometric, biochemical, clinical, physical parameters and psychosocial concerns unique to the kidney disease population. Nutritional therapy is also discussed across the spectrum of kidney disease, and pertinent aspects critical to successful management of disorders and conditions, such as bone disease, obesity, and nephrotic syndrome are explored. Nutrition in Kidney Disease, Second edition highlights cutting edge research in regards to exercise and functional outcomes, malnutrition and the inflammatory response, experimental therapies, and the use of complementary and alternative medicine, with a special emphasis on relevant preventative strategies. |
| adult nephrolithiasis case study: Clinical Management of Urolithiasis Thomas Knoll, Margaret S. Pearle, 2012-07-26 A host of new technologies, techniques, and medical regimens have been introduced over the past 30 years for the diagnosis, management, and prevention of urinary calculi. These range from novel imaging procedures and medical expulsive therapy to interventional treatment options. The contemporary urologist should be familiar with and adept at implementing these new concepts and techniques. Clinical Management of Urolithiasis will serve as a practical guide to every clinically relevant aspect of urolithiasis and its treatment, both surgical and medical. In addition to providing up-to-date evidence-based recommendations regarding stone management, the book reflects the real-life experience of well-known international experts. Each chapter includes tables and algorithms that allow the reader easily to check the requirements for specific procedures and to translate them into clinical practice. |
| adult nephrolithiasis case study: Acute Care and Emergency Gynecology David Chelmow, Christine R. Isaacs, Ashley Carroll, 2014-10-30 Presents almost 100 common and uncommon gynecologic problems encountered in urgent and emergency settings with an emphasis on practical management. |
| adult nephrolithiasis case study: Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate Institute of Medicine, Food and Nutrition Board, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Panel on Dietary Reference Intakes for Electrolytes and Water, 2005-06-18 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate The Dietary Reference Intakes (DRIs) are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. This new report, the sixth in a series of reports presenting dietary reference values for the intakes of nutrients by Americans and Canadians, establishes nutrient recommendations on water, potassium, and salt for health maintenance and the reduction of chronic disease risk. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate discusses in detail the role of water, potassium, salt, chloride, and sulfate in human physiology and health. The major findings in this book include the establishment of Adequate Intakes for total water (drinking water, beverages, and food), potassium, sodium, and chloride and the establishment of Tolerable Upper Intake levels for sodium and chloride. The book makes research recommendations for information needed to advance the understanding of human requirements for water and electrolytes, as well as adverse effects associated with the intake of excessive amounts of water, sodium, chloride, potassium, and sulfate. This book will be an invaluable reference for nutritionists, nutrition researchers, and food manufacturers. |
| adult nephrolithiasis case study: Medical-Surgical Nursing - Single-Volume Text and Elsevier Adaptive Learning Package Sharon L. Lewis, Shannon Ruff Dirksen, Margaret M. Heitkemper, Linda Bucher, 2014-06-17 Corresponding chapter-by-chapter to Medical-Surgical Nursing, 9e, Elsevier Adaptive Learning combines the power of brain science with sophisticated, patented Cerego algorithms to help you learn faster and remember longer. It's fun; it's engaging; and it's constantly tracking your performance and adapting to deliver content precisely when it's needed to ensure core information is transformed into lasting knowledge. Please refer to the individual product pages for the duration of access to these products. An individual study schedule reduces cognitive workload and helps you become a more effective learner by automatically guiding the learning and review process. The mobile app offers a seamless learning experience between your smartphone and the web with your memory profile maintained and managed in the cloud. UNIQUE! Your memory strength is profiled at the course, chapter, and item level to identify personal learning and forgetting patterns. UNIQUE! Material is re-presented just before you would naturally forget it to counteract memory decay. A personalized learning pathway is established based on your learning profile, memory map, and time required to demonstrate information mastery. The comprehensive student dashboard allows you to view your personal learning progress. |
| adult nephrolithiasis case study: Endocrinology and Diabetes Ramzi Ajjan, Stephen M. Orme, 2015-03-26 This book provides case studies accompanied by questions and commentaries for the specialist registrar in diabetes and endocrinology, to assist with problem-based learning during their training. The case studies range from the everyday to the rare and complicated, presenting a strong foundation for the specialist trainee to prepare them for their qualifying exams and, more importantly, for their future clinical consultations. |
| adult nephrolithiasis case study: The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder American Psychiatric Association, 2018-01-11 Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD. |
| adult nephrolithiasis case study: Advanced Practice Nursing in the Care of Older Adults Laruie Kennedy-Malone, Lori Martin-Plank, Evelyn Duffy, 2018-10-31 Meet the diverse health care needs of older adults! Explore effective ways to enhance the wellness and independence of older adults across the wellness-illness continuum, including acute, primary, and long-term care. From an overview of the theories of aging and assessment through the treatment of disorders, including complex illnesses, this evidence-based book provides the comprehensive gerontological coverage you need to prepare for your role as an Advanced Practice Nurse. You’ll be prepared for boards and for practice. |
| adult nephrolithiasis case study: Medical-Surgical Nursing Sharon Mantik Lewis, Margaret McLean Heitkemper, Jean Foret Giddens, Shannon Ruff Dirksen, 2003-12-01 Package includes Medical-Surgical Nursing: Assessment and Management of Clinical Problems Two Volume text and Virtual Clinical Excursions 2.0 |
| adult nephrolithiasis case study: Onco-Nephrology E-Book Kevin W. Finkel, Mark Anthony Perazella, Eric P Cohen, 2019-07-02 Kidney disease and cancer are frequent comorbidities that require specialized knowledge and expertise from both the nephrologist and the oncologist. Written by three pioneers in this growing subspecialty, Onco-Nephrology provides authoritative, definitive coverage of the mechanism and management of these two life-threatening diseases. This unique, single-volume resource covers current protocols and recommends management therapies to arrest kidney failure and allow oncologic treatments to continue and succeed. - Addresses acute and chronic kidney diseases that develop from a variety of cancers. This includes direct kidney injury from the malignancy, paraneoplastic effects of the cancer, and various cancer agents used to treat the malignancy. - Discusses key issues regarding kidney disease in patients with cancer, including conventional chemotherapeutic regimens and new novel therapies (targeted agents and immunotherapies) or the malignancies themselves that may promote kidney injury; patients with chronic kidney disease who acquire cancer unrelated to renal failure; and kidney transplantation, which has been shown to carry an increased risk of cancer. - Contains dedicated chapters for each class of the conventional chemotherapeutic agents, targeted cancer agents, and cancer immunotherapies including the basic science, pathogenic mechanisms of injury, clinical manifestations, and treatment. - Includes special chapters devoted to the individual classes of chemotherapies that relate to kidney disease for quick reference. Discusses increasingly complex problems due to more numerous and specialized anti-cancer drugs, as well as increased survival rates for both cancer and renal failure requiring long-term patient care. - Covers anti-VEGF (antivascular endothelial growth factor) agents and cancer immunotherapies – treatments that are being recognized for adverse kidney effects. - Utilizes a clear, logical format based on the ASN Core Curriculum for Onco-Nephrology, making this reference an excellent tool for board review, as well as a practical resource in daily practice. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. |
| adult nephrolithiasis case study: Folate in Health and Disease Lynn B. Bailey, 2009-11-24 During the fifteen years since the bestselling first edition of Folate in Health and Disease was published, there have been thousands of new research studies related to folate and its role in health and disease. The second edition of the book uniquely bridges the gap between basic science and public health/clinical medicine.Presents Groundbreaking |
| adult nephrolithiasis case study: Case Studies in Medical Toxicology Leslie R. Dye, Christine Murphy, Diane P. Calello, Michael D. Levine, Aaron Skolnik, 2017-12-22 The ACMT National Case Conference (NCC) is a monthly discussion of novel or interesting cases in medical toxicology. Participation is through online webinar, and the conferences are recorded to allow for review at any time. The cases in this book are taken from recordings of NCC with edits and revisions by contributors and editors to demonstrate educational points. The majority of the case information is from the original recording and represents actual patient presentations. However, some of the details have been changed and fictional information added to enhance the educational value. This volume covers a broad range of toxicological topics, and specialty guidance is offered at the end of every case to aid non-toxicologists. The dilemmas are applicable to both academic and clinical medicine. A list of relevant questions is also provided for each case. Subjects include common toxicological problems, rare presentations of common problems, common problems with controversial treatments or difficult diagnoses, and rare problems. Case Studies in Medical Toxicology from the American College of Medical Toxicology is a detailed reference text on specific toxicological issues and also serves as a practical review for those taking board exams. As a result, this volume is an important and necessary resource for medical students, residents, and fellows, as well as primary-care physicians, intensivists, and toxicologistsCase Studies in Medical Toxicology from the American College of Medical Toxicology is a detailed reference text on specific toxicological issues and also serves as a practical review for those taking board exams. As a result, this volume is an important and necessary resource for medical students, residents, and fellows, as well as primary-care physicians, intensivists, and toxicologists. All proceeds from this book will be donated to the Medical Toxicology Foundation. |
| adult nephrolithiasis case study: CURRENT Diagnosis & Treatment Nephrology & Hypertension Edger Lerma, Jeffrey S. Berns, Allen R. Nissenson, 2008-10-31 A complete clinically focused guide to managing the full spectrum of kidney diseases and hypertension A Doody's Core Title! an up-to-date, accessible guide that covers all major clinical aspects of the adult patient with diseases involving the kidneys and hypertension. Numerous figures and tables are well integrated into structured chapters creating an easy flow of information that helps readers capture key points....In contrast to many other books in this area, this one provides a concise yet comprehensive review of each topic without getting lost in too much detail that interested readers can find in other places. It is a clinically useful tool for anybody interested in the field....Given its concise but comprehensive structure, this book is a great resource for students and residents who want to review basic physiology and pathophysiology but also get up-to-date information on diagnosis and therapy. The wide range of topics also makes it a useful tool for any clinicians at a more senior level who want to quickly review a particular subject. Lastly, due to its easily accessible structure, patients and families seeking medical information also might find it useful. 3 Stars.--Doody's Review Service Presented in the consistent, easy-to-follow CURRENT style, CURRENT Diagnosis & Treatment Nephrology & Hypertension offers incisive, ready-to-use management protocols and valuable therapeutic guidelines -- from authors who are recognized as the field's foremost authorities. Accessible, concise, and up-to-date, CURRENT Diagnosis & Treatment Nephrology & Hypertension features: One-of-a-kind clinical overview of all major diseases and disorders, from end-stage renal disease to primary and secondary hypertension A practical, learn-as-you-go approach to diagnosing and treating renal disorders and hypertension that combines disease management techniques with the latest clinically proven therapies Up-to-date coverage of transplantation medicine and need-to-know interventional procedures An important review of subspecialty considerations: renal disease in the elderly, diabetic nephropathy, critical care nephrology, and dialysis Expert authorship from prominent clinicians in the areas of kidney disease, dialysis, and hypertension |
| adult nephrolithiasis case study: Clinical Decisions in Pediatric Nephrology Farahnak Assadi, 2007-11-24 Evidenced-based medicine approach Question-Answer format |
| adult nephrolithiasis case study: Urinary Stones Michael Grasso, David Goldfarb, 2014-04-14 Acute urinary stones cause one of the most painful sensations the human body can experience, more painful than childbirth, broken bones, gunshot wounds or burns. Master your patient management with this comprehensive guide to a debilitating medical condition. Urinary Stones: Medical and Surgical Management provides urologists, nephrologists and surgeons with a practical, accessible guide to the diagnosis, treatment and prevention of urinary stone disease. Divided into 2 parts – covering both medical and surgical management - leading experts discuss the key issues and examine how to deliver best practice in the clinical care of your patients. Topics covered include: Evaluation and management of stones in children Renal colic and medical expulsive therapy Imaging in stone disease: sonography, contrast based fluoroscopy, computed tomography and magnetic resonance urography Multimodality therapy: mixing and matching techniques to improve outcome Complications of stone disease Interpretation of 24 hour urine chemistry Prevention of recurrent calcium, uric acid, struvite and cystine stones The different surgical techniques, including: ureteroscopy, shockwave lithotripsy, ureteroscopic lithotripsy and percutaneous nephrostolithotomy Packed with high-quality figures, key points, and management algorithms, easy to follow, clear clinical guidance is supported by the very latest in management guidelines from the AUA and EAU. Brought to you by the best, this is the perfect consultation tool when on the wards or in the office. |
| adult nephrolithiasis case study: Comprehensive Clinical Nephrology E-Book Jurgen Floege, Richard J. Johnson, John Feehally, 2010-11-08 Comprehensive Clinical Nephrology provides you with all the tools you need to manage all forms of kidney disease. Drs. Jürgen Floege, Richard J. Johnson, John Feehally and a team of international experts have updated this fourth edition to include hot topics such as treatment of hypertensive emergencies, herbal and over-the-counter medicines and the kidney, neurologic complications of the kidney, and more. This essential resource gives you quick access to today’s best knowledge on every clinical condition in nephrology. Make efficient, informed decisions with just the right amount of basic science and practical clinical guidance for every disorder. Diagnose effectively and treat confidently thanks to more than 1100 illustrations, abundant algorithms, and tables that highlight key topics and detail pathogenesis for a full range of kidney conditions and clinical management. Get coverage of the latest developments in the field with 18 new chapters on the Management of the Diabetic Patient with Chronic Kidney Disease, Treatment of Hypertensive Emergencies, Principles of Drug Dosing and Prescribing of Chronic Kidney Disease, Herbal and Over-the-Counter Medicines and the Kidney, Neurologic Complications of the Kidney, and more. Tap into the experience and expertise of the world’s leading authorities in the field of nephrology. Floege, Johnson, and Feehally give you the information you need to make quick and correct clinical decisions |
| adult nephrolithiasis case study: Pathology: The Big Picture William Kemp, Dennis K. Burns, Travis G. Brown, 2007-08-22 Get the BIG PICTURE of Pathology - and focus on what you really need to know to score high on the course and board exam If you want a streamlined and definitive look at Pathology - one with just the right balance of information to give you the edge at exam time - turn to Pathology: The Big Picture. You'll find a succinct, user-friendly presentation especially designed to make even the most complex concept understandable in the shortest amount of study time possible. This perfect pictorial and textual overview of Pathology delivers: A “Big Picture” emphasis on what you must know verses “what's nice to know” Expert authorship by award-winning, active instructors Coverage of the full range of pathology topics - everything from cellular adaptations and injury to genetic disorders to inflammation to diseases of immunity Magnificent 4-color illustrations Numerous summary tables and figures for quick reference and rapid retention of even the most difficult topic Highlighted key concepts that underscore integral aspects of histology (key concepts are also listed in a table at the end of each chapter) USMLE-type questions, answers, and explanations to help you anticipate what you'll encounter on the exams And much more! |
| adult nephrolithiasis case study: Pocket Book of Hospital Care for Children World Health Organization, 2013 The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem. |
| adult nephrolithiasis case study: CURRENT Diagnosis & Treatment Nephrology & Hypertension, 2nd Edition Edger Lerma, Mitchell H. Rosner, Mark A. Perazella, 2018-01-12 A practical, up-to-date guide to the diagnosis, understanding, and treatment of kidney problems and hypertension in adult patients “In contrast to many other books in this area, this one provides a concise yet comprehensive review of each topic without getting lost in too much detail...” – Doody’s Review Service (review of previous edition) Presented in the consistent, easy-to-follow CURRENT format, CURRENT Diagnosis & Treatment Nephrology & Hypertension, Second Edition delivers incisive, ready-to-use management protocols and valuable therapeutic guidelines from authors who are recognized as the field’s foremost authorities. This essential clinical companion features a practical learn-as-you-go approach to diagnosing and treating renal disorders and hypertension that combines disease management techniques with the latest proven therapies. •NEW! Chapter-ending clinically based Q&A •NEW CHAPTERS include The Kidney in Malignancy, Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD), Palliative Care Nephrology, and Clinical Pharmacology and the Kidney •Fifty-nine chapters deliver a one-of-a-kind overview of all major diseases and disorders, from end-stage renal disease to primary and secondary hypertension •Emphasizes the clinical aspects of kidney care, while also providing comprehensive discussion of pathophysiology and relevant basic and clinical science •Includes an important review of subspecialty considerations: dialysis, transplantation, critical care nephrology, interventional nephrology, palliative care nephrology, clinical renal pharmacology, as well as a new area of specialization – onco-nephrology •Consistently formatted chapters make it easy to locate the essential information you need on diagnosis, testing, disease processes, and the latest treatment and management strategies •Valuable as a clinical refresher or for board review •Strikes the perfect balance between clinical necessity and brevity |
| adult nephrolithiasis case study: Urolithiasis Jamsheer J. Talati, Hans-Goran Tiselius, David M. Albala, ZHANGQUN YE, 2012-12-22 Urolithiasis: Basic Science and Clinical Practice is a comprehensive text that assists urologists in defining the best choice of treatment for each case through a balanced presentation of underlying science, diagnostic methods and practical tips, with additional discussions on educational issues, costs and management of resources. This user-friendly practical resource is replete with full-color illustrations and radiographs, covering all aspects of stone disease, and offering perspectives from Europe, the Americas, China, South Asia, Africa, and Australia. Topics include the biochemical and physiological basis of stone formation, treatment options, complications, assessment of techniques and technologies available, and guidelines on the prevention of stone recurrence. Urolithiasis: Basic Science and Clinical Practice is the definitive text on stone disease and is a must read for young consultants starting a new practice, and urologists in residence and training. |
| adult nephrolithiasis case study: Chronic Prostatitis/Chronic Pelvic Pain Syndrome Daniel A. Shoskes, 2008-06-26 Chronic Prostatitis is a common and debilitating condition affecting 5-12% of men worldwide. The most common form is category III, or Chronic Pelvic Pain Syndrome. Cutting-edge clinical research has led to advancements in the diagnosis and treatment of prostatitis, a group of conditions that is at once extremely common, poorly understood, inadequately treated and under-researched. In Chronic Prostatitis/Chronic Pelvic Pain Syndrome, the author provides today’s most current information covering the four categories of prostatitis (acute, chronic bacterial, CPPS and asymptomatic inflammation). A diverse international group of contributors that includes urologists (academic, primary care and front line private practice), scientists, psychologists, and pain specialists from the National Institutes of Health provide the reader with novel approaches to helping their patients. The chapters in this important new work cover general evaluation of the prostatitis patient, the approach to acute prostatitis, chronic bacterial prostatitis and chronic pelvic pain syndrome, evidence behind individual therapies and ancillary topics such as erectile dysfunction, infertility, the link between chronic prostatitis and prostate cancer, male interstitial cystitis and the potential etiologic role of calcifying nanoparticles. Chronic Prostatitis/Chronic Pelvic Pain Syndrome offers novel approaches to diagnosing this condition as well as providing ways in which to ease the suffering of the patient with prostatitis. |
| adult nephrolithiasis case study: Toxicology of the Kidney Jerry B. Hook, Robin S. Goldstein, 1993-06-30 This second edition provides a synthesis of recent research on the mechanisms of chemically-induced kidney injury. The text includes a review of current concepts of clinical nephrotoxicity and renal failure, and mechanisms of specific classes of nephrotoxic drugs and environmental chemicals. |
| adult nephrolithiasis case study: Metabolic Bone Disease and Clinically Related Disorders Louis V. Avioli, Stephen M. Krane, 1997-10-08 Metabolic Bone Disease, Third Edition is the new, expanded edition of the classic text, featuring the latest advancements and research information in this fast-moving field. The Third Edition includes the most up-to-date information on molecular mechanisms, basic biology, pathophysiology, and diagnosis and management strategies of metabolic bone disease. - Edited by fathers of the field - An expanded version of a classic AP text - Complete coverage of a fast-growing field |
| adult nephrolithiasis case study: Kidney Stone Disease David A. Schulsinger, 2014-12-11 Kidney stone is a significant disease with a 12-15% prevalence in the United States. Patients with a history of stones have a 50% risk of making another stone in 5 years or 80% risk in their lifetime. The goal of this book is to educate the reader on the nuts and bolts of stone disease and to provide new and updated information to help them tackle this painful disease. |
| adult nephrolithiasis case study: The Patient History: Evidence-Based Approach Mark Henderson, Lawrence Tierney, Gerald Smetana, 2012-06-13 The definitive evidence-based introduction to patient history-taking NOW IN FULL COLOR For medical students and other health professions students, an accurate differential diagnosis starts with The Patient History. The ideal companion to major textbooks on the physical examination, this trusted guide is widely acclaimed for its skill-building, and evidence based approach to the medical history. Now in full color, The Patient History defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. The second edition features all-new chapters, case scenarios, and a wealth of diagnostic algorithms. Introductory chapters articulate the fundamental principles of medical interviewing. The book employs a rigorous evidenced-based approach, reviewing and highlighting relevant citations from the literature throughout each chapter. Features NEW! Case scenarios introduce each chapter and place history-taking principles in clinical context NEW! Self-assessment multiple choice Q&A conclude each chapter—an ideal review for students seeking to assess their retention of chapter material NEW! Full-color presentation Essential chapter on red eye, pruritus, and hair loss Symptom-based chapters covering 59 common symptoms and clinical presentations Diagnostic approach section after each chapter featuring color algorithms and several multiple-choice questions Hundreds of practical, high-yield questions to guide the history, ranging from basic queries to those appropriate for more experienced clinicians |
| adult nephrolithiasis case study: The American Almanac and Repository of Useful Knowledge for the Year 1861 Anonymous, 2022-06-03 Reprint of the original, first published in 1861. |
| adult nephrolithiasis case study: Surgical Management of Urolithiasis Stephen Y. Nakada, Margaret S. Pearle, 2013-05-18 Written entirely by surgical urologists, Surgical Management of Urolithiasis: Percutaneous, Shockwave and Ureteroscopy presents a comprehensive overview of the past, present, and future of surgical techniques, with a focus on educating urologists on the full spectrum of stone procedures. In addition to the technical issues, detailed complications are described. Basic as well as advanced techniques are presented in both a didactic and visual mode with representative endoscopic images and radiographs. Recent advancements which are not routinely a core component of surgical training programs are also covered in detail. Compact and extensively illustrated, Surgical Management of Urolithiasis: Percutaneous, Shockwave and Ureteroscopy is a unique and valuable resource in the field of surgical urolithiasis, essential both for those currently in training and for those already in clinical practice. |
| adult nephrolithiasis case study: Urologic Surgery James Francis Glenn, William H. Boyce, 1969 |
| adult nephrolithiasis case study: Evidence-Based Imaging L. Santiago Medina, C. Craig Blackmore, Kimberly Applegate, 2011-04-28 Evidence-Based Imaging is a user-friendly guide to the evidence-based science and merit defining the appropriate use of medical imaging in both adult and pediatric patients. Chapters are divided into major areas of medical imaging and cover the most prevalent diseases in developed countries, including the four major causes of mortality and morbidity: injury, coronary artery disease, cancer, and cerebrovascular disease. This book gives the reader a clinically-relevant overview of evidence-based imaging, with topics including epidemiology, patient selection, imaging strategies, test performance, cost-effectiveness, radiation safety and applicability. Each chapter is framed around important and provocative clinical questions relevant to the daily physician’s practice. Key points and summarized answers are highlighted so the busy clinician can quickly understand the most important evidence-based imaging data. A wealth of illustrations and summary tables reinforces the key evidence. This revised, softcover edition adds ten new chapters to the material from the original, hardcover edition, covering radiation risk in medical imaging, the economic and regulatory impact of evidence-based imaging in the new healthcare reform environment in the United States, and new topics on common disorders. By offering a clear understanding of the science behind the evidence, Evidence-Based Imaging fills a void for radiologists, family practitioners, pediatricians, surgeons, residents, and others with an interest in medical imaging and a desire to implement an evidence-based approach to optimize quality in patient care. |
| adult nephrolithiasis case study: Adult Short Bowel Syndrome Mandy L. Corrigan, Kristen Roberts, Ezra Steiger, 2018-10-09 Adult Short Bowel Syndrome: Nutritional, Medical, and Surgical Management serves as a practical guide to the medical, surgical and nutritional care of complex patients with Short Bowel Syndrome (SBS), providing information on SBS with the most up-to-date, evidence-based data available. Additionally, the book presents global perspectives and highlights emerging areas of research that are influencing the care of patients with SBS. Intended for nutritionists, dieticians, physicians (specifically, general practitioners, gastroenterologists, and surgeons), nurse practitioners, pharmacists, students and researchers, this book serves as a quick reference on the medical, surgical and nutritional care of complex patients with short bowel syndrome. - Presents emerging areas of research related to Short Bowel Syndrome (gut microbiome, pre/probiotics), as well as current applications in clinical practice - Compiles an overview, classification and complications of the Short Bowel Syndrome disease state - Contains effective dietary concepts (including rationale and use of oral rehydration solutions) for managing malabsorption caused by Short Bowel Syndrome - Includes medical and pharmaceutical management techniques to compliment nutrition interventions - Discusses surgical options for consideration in patients with Short Bowel Syndrome - Highlights international perspectives on treatment and care |
| adult nephrolithiasis case study: Pathophysiology of Disease: An Introduction to Clinical Medicine 7/E (ENHANCED EBOOK) Gary D. Hammer, Stephen J. McPhee, 2014-03-22 A full-color, case-based review of the essentials of pathophysiology--covering all major organs and systems The goal of this trusted text is to introduce you to clinical medicine by reviewing the pathophysiologic basis of 120 diseases (and associated signs and symptoms) commonly encountered in medical practice. The authors, all experts in their respective fields, have provided a concise review of relevant normal structure and function of each body system, followed by a description of the pathophysiologic mechanisms that underlie several common diseases related to that system. Each chapter of Pathophysiology of Disease concludes with a collection of case studies and questions designed to test your understanding of the pathophysiology of each clinical entity discussed. These case studies allow you to apply your knowledge to specific clinical situations. Detailed answers to each case study question are provided at the end of the book. This unique interweaving of physiological and pathological concepts will put you on the path toward thinking about signs and symptoms in terms of their pathophysiologic basis, giving you an understanding of the why behind illness and treatment. Features 120 case studies (9 new) provide an opportunity for you to test your understanding of the pathophysiology of each clinical entity discussed Checkpoint questions provide review and appear in every chapter Updates and revisions throughout this new edition reflect the latest research and developments Numerous tables and diagrams encapsulate important information Updated references for each chapter topic Pathophysiology of Disease is a true must-have resource for medical students preparing for the USMLE Step 1 exam, as well as students engaged in their clerkship studies. House officers, nurses, nurse practitioners, physicians’ assistants, and allied health practitioners will find its concise presentation and broad scope a great help in facilitating their understanding of common disease entities. |
| adult nephrolithiasis case study: Endourology Culley C. Carson, N. Reed Dunnick, 1985 |
abbreviations - What do CI, CIM, CID, CIB mean? - English …
Apr 9, 2014 · I was talking to a friend about a girl, and he mentioned that “She can pretty much CI anything, CIB, CIM or CID.” I’m wondering what these mean. The context was sexual …
possessives - adults’ English teacher or adult’s English teacher ...
Sep 6, 2019 · Use a noun adjunct. "I am an adult English teacher." It still has ambiguity, namely whether you are an adult who teaches English or whether you teach English to adults, but my …
Referring to adult-age sons and daughters as children
Dec 21, 2012 · "adult children" is sometimes used in contexts where age is important, such as a form requiring someone to list all children under 18 and all adult children living with them. And …
Specific word for "grown-up children"? [duplicate]
Mar 5, 2014 · There is a group the ACA (Adult Children of Alcoholics) whose website is adultchildren.org So, this is definitely a common usage. – David M Commented Mar 4, 2014 at …
single word requests - English Language & Usage Stack Exchange
From the Wikipedia entry for 'young adult': A young/prime adult, according to Erik Erikson's stages of human development, is generally a person between the age of 20 - 40, whereas an …
Use of 'as per' vs 'per' - English Language & Usage Stack Exchange
Similarly, cops cop: instead of "a man" we find employed "an adult male individual". Tinhorns have to blow hard--such is the nature of tin--and so come to be known as blowhards. *"per" is here …
What do you call a person who has a relationship with a much …
Aug 20, 2015 · Stack Exchange Network. Stack Exchange network consists of 183 Q&A communities including Stack Overflow, the largest, most trusted online community for …
Can "Mr", "Mrs", etc. be used with a first name?
Jan 7, 2012 · As Mr. England's post indicates, common usage dictates the rules, not the other way around. And in the South, this is very common and accepted. It can be a bit rude (or at …
How offensive is it to call someone a "slag" in British English?
One more colorful slang term I gleaned from the British movie I recently watched is slag. In the movie, it was used in curses like, "Fuck-ing dogs! Slags." "Right slag, that one." Now I know via
问问前辈们，有什么适合打R18mod的steam游戏吗？ - 知乎
知乎，中文互联网高质量的问答社区和创作者聚集的原创内容平台，于 2011 年 1 月正式上线，以「让人们更好的分享知识、经验和见解，找到自己的解答」为品牌使命。知乎凭借认真、专业 …
abbreviations - What do CI, CIM, CID, CIB mean? - English …
Apr 9, 2014 · I was talking to a friend about a girl, and he mentioned that “She can pretty much CI anything, CIB, CIM or CID.” I’m wondering what these mean. The context was sexual …
possessives - adults’ English teacher or adult’s English teacher ...
Sep 6, 2019 · Use a noun adjunct. "I am an adult English teacher." It still has ambiguity, namely whether you are an adult who teaches English or whether you teach English to adults, but my …
Referring to adult-age sons and daughters as children
Dec 21, 2012 · "adult children" is sometimes used in contexts where age is important, such as a form requiring someone to list all children under 18 and all adult children living with them. And …
Specific word for "grown-up children"? [duplicate]
Mar 5, 2014 · There is a group the ACA (Adult Children of Alcoholics) whose website is adultchildren.org So, this is definitely a common usage. – David M Commented Mar 4, 2014 at …
single word requests - English Language & Usage Stack Exchange
From the Wikipedia entry for 'young adult': A young/prime adult, according to Erik Erikson's stages of human development, is generally a person between the age of 20 - 40, whereas an …
Use of 'as per' vs 'per' - English Language & Usage Stack Exchange
Similarly, cops cop: instead of "a man" we find employed "an adult male individual". Tinhorns have to blow hard--such is the nature of tin--and so come to be known as blowhards. *"per" is here …
What do you call a person who has a relationship with a much …
Aug 20, 2015 · Stack Exchange Network. Stack Exchange network consists of 183 Q&A communities including Stack Overflow, the largest, most trusted online community for …
Can "Mr", "Mrs", etc. be used with a first name?
Jan 7, 2012 · As Mr. England's post indicates, common usage dictates the rules, not the other way around. And in the South, this is very common and accepted. It can be a bit rude (or at …
How offensive is it to call someone a "slag" in British English?
One more colorful slang term I gleaned from the British movie I recently watched is slag. In the movie, it was used in curses like, "Fuck-ing dogs! Slags." "Right slag, that one." Now I know via
问问前辈们，有什么适合打R18mod的steam游戏吗？ - 知乎
知乎，中文互联网高质量的问答社区和创作者聚集的原创内容平台，于 2011 年 1 月正式上线，以「让人们更好的分享知识、经验和见解，找到自己的解答」为品牌使命。知乎凭借认真、专业 …
