RESUMO
Climate change is one of the greatest threats to human health in the 21st century. The human health impacts of climate change contribute to approximately 1 in 4 deaths worldwide. Health care itself is responsible for approximately 5% of annual global greenhouse gas (GHG) emissions. Canada is a recent signatory of the 26th United Nations Climate Change Conference (COP26) health agreement that is committed to developing low carbon and climate resilient health systems. Kidney care services have a substantial environmental impact and there is opportunity for the kidney care community to climate align clinical care. We introduce a framework of redesigned kidney care and describe examples of low carbon kidney disease management strategies to expand our duty of care to the environment which completes the triple bottom line of optimal patient outcomes and cost effectiveness in the Anthropocene.
Assuntos
Estado Terminal , Hipotensão , Humanos , Prevalência , Diálise Renal , Terapia de Substituição Renal , Fatores de RiscoRESUMO
Morganella morganii is a rare cause of peritonitis in patients on peritoneal dialysis (PD). Most of the reported cases have resorted to a switch to hemodialysis. We herein report a case of peritonitis due to M. morganii resistant to third-generation cephalosporins, which was treated successfully with intraperitoneal (IP) tobramycin followed by oral ciprofloxacin. Early microbiologic diagnosis is essential in the treatment of peritonitis from rare microorganisms such as Morganella morganii, and appropriate antibiotic therapy is the key to avoiding catheter loss and subsequent switch to hemodialysis.
Assuntos
Ciprofloxacina/administração & dosagem , Infecções por Enterobacteriaceae/tratamento farmacológico , Diálise Peritoneal/efeitos adversos , Peritonite/tratamento farmacológico , Peritonite/microbiologia , Tobramicina/administração & dosagem , Centros Médicos Acadêmicos , Administração Oral , Cefalosporinas/administração & dosagem , Resistência Microbiana a Medicamentos , Quimioterapia Combinada , Infecções por Enterobacteriaceae/diagnóstico , Feminino , Seguimentos , Humanos , Infusões Parenterais , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/terapia , Pessoa de Meia-Idade , Morganella morganii/efeitos dos fármacos , Morganella morganii/isolamento & purificação , Diálise Peritoneal/métodos , Peritonite/etiologia , Resultado do TratamentoRESUMO
The IP-based Ubiquitous Sensor Network (IP-USN) is an effort to build the "Internet of things". By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System) called RIDES (Robust Intrusion DEtection System) for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control) technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components.
