Research, Perspectives, and Recommendations on Implementing the Flipped Classroom.

Flipped or inverted classrooms have become increasingly popular, and sometimes controversial, within higher education. Many educators have touted the potential benefits of this model and initial research regarding implementation has been primarily positive. The rationale behind the flipped classroom methodology is to increase student engagement with content, increase and improve faculty contact time with students, and enhance learning.

Right atrium thrombosis in patients on hemodialysis.

Vascular access has been the Achilles heel of hemodialysis for many years, and placement of temporary subclavian and internal jugular vein catheters has been a daily practice for the nephrologist. Now, concern about central vein stenosis, well described with the use of subclavian catheters in end-stage renal disease (ESRD), has prompted the use of internal jugular vein permanent catheters to avoid this complication, so as not to hinder future arteriovenous grafts. Permanent catheter access is not without its own special problems, and we describe here two patients that developed thrombosis of the right atrium while receiving hemodialysis through a permanent internal jugular catheter.

Quantitative ultrasonic detection of parenchymal structural change in diffuse renal disease.

Objective: The authors determined whether quantitative ultrasound could be useful in the evaluation of diffuse renal disease.

Methods: Digitized radiofrequency ultrasound data were acquired from the kidneys of patients with biopsy-proven diffuse renal disease and transplant rejection (37 patients plus 18 normal volunteers). The results of the quantitative analysis were compared with histology results to determine if microscopic renal structure could be correlated with quantitative features such as scatterer size and scatterer spacing.

Does low-calcium dialysate accelerate secondary hyperparathyroidism in continuous ambulatory peritoneal dialysis patients?

A lower-calcium dialysate has been advocated for continuous ambulatory peritoneal dialysis (CAPD) patients for the purpose of increasing oral calcium intake as a phosphate binder and decreasing the need for aluminum-containing phosphate binders and, hence, decreasing the risk of aluminum intoxication. Twelve CAPD patients were evaluated retrospectively after switching from a dialysate containing 3.5 mEq/L of calcium to a new dialysate containing 2.

Low-dose subcutaneous erythropoietin in continuous ambulatory peritoneal dialysis.

We evaluated changes in hematocrit in patients on continuous ambulatory peritoneal dialysis (CAPD) before and after the administration of erythropoietin (EPO). Thirty-five patients were evaluated at the beginning of treatment with CAPD and after an average of 3.5 years on CAPD; mean hematocrit (Hct) rose from 25.

Ten years' experience with continuous ambulatory peritoneal dialysis.

Up to January 1989, 171 patients were trained at our center on continuous ambulatory peritoneal dialysis (CAPD), and 17 on continuous cyclic peritoneal dialysis (CCPD). Over 10 years, we have gained 5,068 patient-months experience. Patient survival was 60% and 31% at 5 and 10 years, respectively.

Polycystic kidneys do maintain good endocrine function.

We develop here the hypothesis that polycystic kidneys (PCK) may maintain, to a certain extent, the ability to perform endocrine functions. We know that patients with adult polycystic kidney disease (APCKD) produce more erythropoietin and maintain a higher hematocrit than patients with other primary diseases of the kidneys. It is possible that they synthesize more 1,25 and 24,25 Vit D3 and metabolize better the parathyroid hormone and other hormones.

Chronic dialysis in a patient with cystic fibrosis.

To our knowledge this is the first case reported in the literature of a patient with cystic fibrosis and end-stage renal disease, who was on dialysis for 2 years. We discuss here the possible mechanisms responsible for what has been called 'the cystic fibrosis nephropathy' and its consequences.

Immune stimulation. A new approach in the treatment of glomerulonephritis.

We discuss here a new approach to the treatment of idiopathic membranous glomerulonephritis (IMGN). Steroids and cytotoxic drugs have been used during the last years for the treatment of this disease, but the results are controversial. We develop here the hypothesis that the pathogenesis of IMGN is a relative incompetence of the immune system in clearing foreign antigens.

Pulmonary hemorrhage and glomerulonephritis in the absence of anti-glomerular basement membrane antibody.

We have described a case of pulmonary hemorrhage and idiopathic crescentic glomerulonephritis unrelated to anti-glomerular basement membrane antibodies and/or immune complexes. Although pulmonary hemorrhage was controlled dramatically with high doses of corticosteroids, renal function declined rapidly.

Sclerosing encapsulating peritonitis in rats induced by long-term intraperitoneal administration of antiseptics.

Continuous ambulatory peritoneal dialysis (CAPD) is an effective long-term treatment for renal failure. Sclerosing encapsulating peritonitis (SEP) is a rare but devastating complication of CAPD and may be caused by long-term peritoneal antiseptic exposure. We examined the peritoneal injury resulting from daily inoculations of moderately high concentrations of the following antiseptics: povidone-iodine, Dakin's solution, Amuchina, and Ampercide.

Bilateral nephrectomy and dialysis as an option for patients with bilateral renal cancer.

Six patients who underwent bilateral nephrectomy for renal carcinoma were placed on maintenance dialysis; of these, 1 patient had a renal transplant. A 5-year 44% survival of these patients was observed. We feel that radical nephrectomy followed by chronic dialysis is a reasonable alternative and offers a fair prognosis to patients with bilateral renal cancer in which partial nephrectomy is not possible.