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The old paternalistic system, where doctors could decide what to tell patients about the risks involved in a procedure, has gone. In this article, the authors describe how the requirements around informed consent are now clearly defined and need to be heeded. [ABSTRACT FROM AUTHOR]

This paper compares the overall water balance of two contrasting cities. Glasgow and Beijing have different soil and climate characteristics and also different water resource policies. Glasgow uses remote rural surface water catchments while Beijing relies more on groundwater. Both cities are introducing sustainable water management policies in various forms. In the case of Glasgow the policies are more directed to flood alleviation while in Beijing one of the drivers is groundwater recharge. The overall water balance of the two cities is modelled using an integrated three-stage numerical tank model. This model represents the processes of infiltration, evaporation, runoff and storage for both paved and unpaved surfaces and indicates the overall water balance over a typical year. The results of the modelling highlight the importance of evaporation in the overall urban water balance and the potential for using stormwater runoff to reduce water demand or to recharge groundwater. [ABSTRACT FROM AUTHOR]

This article is based on the Nephrology chapter in Medical Mistakes – Key Medical Issues in Clinical Negligence Cases published by Claerhout Publishing in 2007. It provides an overview of renal medicine, how renal problems are detected, common diseases of the kidneys and treatment. [ABSTRACT FROM AUTHOR]

The world of clinical negligence is facing and will continue to face major upheavals in the delivery of justice. The speciality depends on a heady witch's brew of claimants, doctors, experts, lawyers and judiciary, not to mention the political interests of the legislature, the financial interests of the accountants and, finally and most importantly, the moral interests of society. From our jaded perspective of about 40 years joint experience in the medico-legal skin trade we offer the benefits of our wisdom. In the dark moments late at night, answering difficult questions from lawyers, we do understand that 'Medical experts are like sewers - what you get out of them depends on what you put into them' (after Tom Lehrer) but we believe that the ideal instructing lawyer is able to prepare the scene in such a way that we can produce prompt, excellent and clear advice to our legal colleagues. In this article we set out to explore the relationship between medical experts and lawyers by examining the characteristics of the bad lawyer, as it was in the past, is now and might be in the future. [ABSTRACT FROM AUTHOR]

Water from the alluvium of ephemeral rivers in Zimbabwe is increasingly being used. These alluvial aquifers are recharged annually from infiltrating floodwater. Nonetheless, the size of this water resource is not without limit and an understanding of the hydrological processes of an alluvial aquifer is required for its sustainable management. This paper presents the development of a water balance model, which estimates the water level in an alluvial aquifer recharged by surface flow and rainfall, while allowing for abstraction, evaporation and other losses. The model is coupled with a watershed model, which generates inflows from upland catchment areas and tributaries. Climate, hydrological, land cover and geomorphological data were collected as inputs to both models as well as observed flow and water levels for model calibration and validation. The sand river model was found to be good at simulating the observed water level and was most sensitive to porosity and seepage. [ABSTRACT FROM AUTHOR]

Examines the influence of triamterene in the development of renal calculi in Great Britain. Lithogenic properties of triamterene; Occurrence of tubular plugging by crystal laden tubular cells in the renal tissue; Prescription of triamterene in conjunction with thiazide.

Examines the effects of hepatic transplants on primary hyperoxaluria type 1. Association of calcium oxalate nephrolithiasis with idiopathic hypercalciuria; Treatment of hyperoxaluria; Occurrence of renal damage following liver transplant.

Examines the use of acetate and bicarbonate for hemodialysis. Effects of acetate and bicarbonate on the metabolism of patient undergoing hemodialysis; Blood acetate concentration in the body; Effects of hemodialysis on blood pressure.

This paper analyses the temporal and spatial changes in the amount and variability of rainfall in Scotland. The sequential Mann-Kendall test reveals that total annual precipitation has increased across Scotland since the 1970s with increasing trends in variability beginning between the mid-1960s and the mid-1970s. Whilst temporally consistent increasing trends in precipitation totals prevail in the West, many weather stations in the East have experienced subsequent trend turning points in the following two decades, explaining the larger magnitude of the trends in western Scotland in recent decades. Trend analyses on six measures of rainfall variability indicate an increase in rainfall variability during the period 1961-2000, as measured by the intra-annual variance, the winter to summer precipitation ratio and the annual cumulative sum range, with decreasing trends observed in the number of dry days. Periodicities associated with the North Atlantic Oscillation and the Atlantic Multidecadal Oscillation could explain the observed temporal variability of rainfall. [ABSTRACT FROM AUTHOR]

This brief article presents a photograph of the hand of a 35-year-old female haemodialysis patient presented with a painful right index finger. She had a history of tertiary hyperparathyroidism resulting in parathyroidectomy and had poorly controlled hyperphosphataemia. Angiography showed normal blood flow to the antecubital fossa.

PURPOSE AND PATIENTS AND METHODS: The purpose of this article is to report the experience of three centers with combined hepatic and renal transplantation for pyridoxine-resistant primary hyperoxaluria type I (alanine:glyoxylate aminotransferase [EC 2.6.1.44] deficiency), with particular emphasis on the selection criteria and timing of the operation. Nine patients with this inherited disease were treated by combined hepatic and renal transplantation. The former replaces the enzyme-deficient organ while the latter replaces the functionally affected organ. RESULTS: One patient with gross systemic oxalosis died in the immediate postoperative period and another died 8 weeks postoperatively of a generalized cytomegalovirus infection, having shown evidence of biochemical correction. One patient with particularly severe osteodystrophy at the time of the operation died 14 months postoperatively from renal failure due to progressive calcium oxalate nephrocalcinosis involving the transplanted kidney, plus thromboembolic disease. He also had very extensive systemic oxalosis. An additional patient with severe osteodystrophy died 9 months postoperatively. One patient developed hyper-rejection of the kidney and died later of gastrointestinal hemorrhage. The four long-term survivors (22 to 38 months) have remained asymptomatic from the standpoint of their renal disease, with resolution of any manifestations of systemic oxalosis that they may have had. They are either employed or continuing their education. CONCLUSIONS: A prolonged period of end-stage renal failure treated by dialysis regimens that are suitable for non-hyperoxaluric renal failure and extensive systemic oxalosis, particularly oxalotic osteodystrophy, are poor prognostic features. We propose that hepatic transplantation should be considered as definitive treatment before end-stage renal failure develops. This should be supplemented by renal transplantation with vigorous pre- and perioperative hemodialysis to... [ABSTRACT FROM AUTHOR]