IgG4-related retroperitoneal fibrosis with acute kidney injury: a case report and literature review.

IgG4-related retroperitoneal fibrosis is a rare cause of renal dysfunction that usually manifests as obstructive nephropathy (sometimes with extrarenal manifestations). Due to the non-specific symptoms at the onset of the disease and often latent course, special laboratory and instrumental examination methods are usually needed to establish a diagnosis. The article describes a clinical case of a relapse of IgG4-related retroperitoneal fibrosis in a 53-year-old patient, who developed bilateral ureterohydronephrosis with postrenal acute kidney injury after the withdrawal of glucocorticoid therapy. The patient underwent bilateral percutaneous nephrostomy and resumed glucocorticoids at a dose of 30 mg/day. Postobstructive diuresis was 22 L. Treatment resulted in a complete normalization of the creatinine level and transient hypokalemia, which was eliminated with potassium medications. At the final stage of the treatment, bilateral stenting of both ureters was performed with a tapering of glucocorticoids to 5 mg per day with CT control of the retroperitoneal space after 5 months. A clinical case demonstrates that an interruption of glucocorticoid treatment in patients with IgG4-related retroperitoneal fibrosis can lead to ureterohydronephrosis with the development of acute kidney injury. In such cases, stenting of the ureters could be considered an optimal therapeutic option.

Caring in an Algorithmic World: Ethical Perspectives for Designers and Developers in Building AI Algorithms to Fight Fake News.

This article suggests several design principles intended to assist in the development of ethical algorithms exemplified by the task of fighting fake news. Although numerous algorithmic solutions have been proposed, fake news still remains a wicked socio-technical problem that begs not only engineering but also ethical considerations. We suggest employing insights from ethics of care while maintaining its speculative stance to ask how algorithms and design processes would be different if they generated care and fight fake news. After reviewing the major characteristics of ethics of care and the phases of care, we offer four algorithmic design principles. The first principle highlights the need to develop a strategy to deal with fake news on the part of the software designers. The second principle calls for the involvement of various stakeholders in the design processes in order to increase the chances of successfully fighting fake news. The third principle suggests allowing end-users to report on fake news. Finally, the last principle proposes keeping the end-user updated on the treatment in the suspected news items. Implementing these principles as care practices can render the developmental process more ethically oriented as well as improve the ability to fight fake news.