Graves Disease: A form of hyperthyroidism where the thyroid gland produces too much thyroxine which results in various symptoms such as goiter, protruding eyes and skin disorders. More detailed information about the symptoms, causes, and treatments of Graves Disease is available below.

Causes Graves\’ Disease

Graves\’ disease is caused by a malfunctioning of the immune system. Antibodies that usually protect the body against infections, viruses and bacteria, attack the thyroid gland.

The thyroid gland, in turn, produces excess thyroid hormone. It is not known what causes the immune system to attack the thyroid gland. A combination of factors such as heredity, sex, age, stress, smoking, and radiation have been implicated as possible triggers for Graves’ disease.

Graves disease is an autoimmune disorder that is more common in middle-aged women than in any other group of people. The symptoms of Graves disease are caused by hyperthyroidism or overactive thyroid gland, which produces more thyroid hormones than the body can handle. It is not known how the thyroid gland becomes overactive, however. So the exact cause of Graves disease cannot be pinpointed.

Graves\’ disease symptoms

Anxiety

Irritability

Difficulty sleeping

Graves\’ ophthalmopathy

It\’s also fairly common for your eyes to exhibit mild signs of a condition known as Graves\’ ophthalmopathy. In Graves\’ ophthalmopathy, your eyeball bulges out past its protective orbit (exophthalmos). This occurs as tissues and muscles behind your eye swell and cause your eyeball to move forward. Because your eye is so far forward, the front surface of your eye can become dry. Cigarette smokers with Graves\’ disease are more likely to have eye problems.

Thyroid hormone has been recognized as an important factor in brain function, so either too much or too little causes malfunction. In a few patients, the emotional pattern is that of mild euphoria. In others, profound fatigue or weakness may be the most noticeable symptom. The mind is often very active, and the patient may have insomnia. Rarely, patients develop visual or auditory hallucinations or a frank psychosis. The latter may not completely clear up after thyrotoxicosis has been treated, but may result from an underlying condition existing before the Graves\’ disease.

Treatment of Graves\’ disease

Here is list of the methods for treating Graves\’ disease:

Your doctor will prescribe either methimazole (Tapazole) or propylthiouracil (PTU) pills. These drugs act to prevent the thyroid from manufacturing the thyroid hormone.

Anti-thyroid drugs which inhibit production or conversion of the active thyroid hormone.

Surgical removal of most of the thyroid gland is the other alternative for severe cases of Graves\’ disease.

The choice of modality for initial treatment of Graves\’ disease is based on symptoms, individual preference, and the experience of the health care provider. In North America, radioactive iodine is often the first treatment of choice whereas in Europe, the initial choice for treatment is antithyroid drugs.

Many of the treatment modalities for Graves\’ disease render the thyroid gland non-functional and lifetime replacement with synthetic thyroid hormone is required. Some studies indicate that regardless of the treatment chosen, approximately 50% of patients remain hypothyroid (low levels of thyroid hormone) even 10 years after treatment.

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While pinkeye can sometimes be alarming because it may make the eyes extremely red and can spread rapidly, it\’s a fairly common condition and usually causes no long-term eye or vision damage.

What causes it?

Conjunctivitis is caused by infection or irritants, including allergens.

In most cases, such infections aren\’t serious and settle quickly. However, gonorrhoea, herpes and chlamydia can also be passed on during birth, and these may be more damaging.

Conjunctivitis caused by some bacteria and viruses can spread easily from person to person, but are not a serious health risk if diagnosed promptly.

The most common seasonal allergic conjunctivitis risk factor is exposure to an environmental irritant. Specific environment irritants change with the seasons.

Symptoms of Conjunctivitis

Conjunctivitis causes the following symptoms in one or both eyes:

Soreness, often described as a gritty or burning feeling, although this isn\’t always present

Itchiness

Redness of the whites of your eye

Symptoms for the other causes of noninfectious conjunctivitis are dependent on the circumstances (i.e., if the conjunctivitis is caused by smog, the person may experience itchy, red eyes; if the conjunctivitis is caused by a chemical in the eye, the person may experience burning, red eyes and blurred vision).

Bacterial

Red and itchy eyes

Watery or milky discharge or pus-like discharge

Can occur in one or both eyes

Can exhibit slight or marked swelling around the eye

Treatment of Conjunctivitis

Most infectious conjunctivitis is highly contagious and spreads by droplet, fomites, and hand-to-eye inoculation. To avoid transmitting infection, the physician must wash his hands thoroughly and disinfect equipment after examining the patient. The patient should wash his hands thoroughly after touching his eyes or nasal secretions, avoid touching the noninfected eye after touching the infected eye, avoid sharing towels or pillows, and not swim in pools.

Your ophthalmologist may prescribe an eyedrop or ointment to help control the swelling and pain and to help prevent spread of the infection and further damage to your eye.

If you have been diagnosed with conjunctivitis, follow these tips to avoid spreading of the infection:

Wash your hands frequently.

Avoid rubbing your eyes.

Don\’t share washcloths, towels or pillowcases.

Don\’t share eyedrops or cosmetics.

Mast cell stabilisers: because mast cell (a type of white blood cell) plays a major role in allergic reactions, the aim of these drugs is to block the action of mast cells. Examples of these group of drugs include sodium cromoglycate and lodoxamide tromethamine. They are eyedrops, and upon use may cause eye discomfort.

Seasonal Allergic Conjunctivitis

Allergic conjunctivitis may disappear completely when the allergy is managed appropriately. Being aware of and removing your allergic trigger(s) may help you to avert the symptoms associated with this type of conjunctivitis.

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A cold sore is a small blister that is reddish or purple. They are usually on the outer edge of the lip, on just one side. Cold sores can appear one at a time or in little bunches, and they are sometimes filled with fluid. They usually crust over and form a scab before they go away. They last a week or 2 and usually don\’t require any special treatment.

What are the symptoms?

The first symptoms of cold sores may include pain around your mouth and on your lips, a fever, a sore throat, or swollen glands in your neck or other parts of the body. Small children sometimes drool before cold sores appear. After the blisters appear, the cold sores usually break open, leak a clear fluid, and then crust over and disappear after several days to 2 weeks. For some people, cold sores can be very painful

Pain or tingling, called the prodrome, often precedes the blisters by one to two days

Usual duration of seven to 10 days

Cold Sore Causes

The virus that causes cold sores is known as the herpes simplex virus (HSV). There are two types of HSV, type I and type II. Cold sores are usually caused by type I. Herpes simplex infections are contagious. The virus is spread from person to person by kissing or other close contact with sores or even from contact with apparently normal skin that is shedding the virus.

When someone gets infected with HSV-1, the virus makes its way through the skin and into a group of nerve cells called a ganglion (pronounced: gang-glee-in). The virus moves in here, takes a long snooze, and every now and then decides to wake up and cause a cold sore. But not everyone who gets the herpes simplex virus develops cold sores.

How can I prevent them?

Preventing recurrences involves avoiding those things known to trigger cold sores. So, make sure you always wear a lip balm containing UV protection and avoid sources of stress.

How are cold sores diagnosed?

A combination of the patient\’s medical history and the appearance of the sores will usually be sufficient for a diagnosis. A scrape or a blood sample can be used to confirm it.

Cold Sores Treatment

Free Dermatology CME for Family Physicians

Most cold sores will clear up on their own after 7-10 days. Most treatment options are focused on reducing the discomfort and pain associated with cold sores and reducing the length of the outbreak. Some treatment options may even help prevent cold sore blisters from forming.

Reduce the number of lesions developed if taken soon enough

Reduce the size of lesions developed if taken soon enough

Reduce the amount of viral shedding

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Healthy kidneys remove waste from your blood. The waste then leaves your body in your urine. The kidneys also help control blood pressure and make red blood cells.

When the kidneys are damaged, they cannot remove waste from the blood as well as they should. This is called chronic kidney disease. Almost 20 million people in the United States have this disease.

What are the symptoms of CKD?

Most people don\’t have any symptoms early in the disease. Once the disease progresses, the symptoms can include the following:

Feeling tired

Feeling weak

Loss of appetite

High blood pressure (hypertension) may develop as a result of kidney damage. This may exacerbate the problem by damaging the kidneys further. However, progress of the disease is usually very slow and it may go undetected for years.

Puffiness around the eyes, swelling of the hands and feet

Pain in the small of the back just below the ribs

High blood pressure

Causes of Chronic Kidney Disease

Unlike acute renal failure, chronic renal failure slowly gets worse. It most often results from any disease that causes gradual loss of kidney function. It can range from mild dysfunction to severe kidney failure. The disease may lead to end-stage renal disease (ESRD).

Kidney disease present at birth (congenital)

Bladder outlet obstruction

Overexposure to toxins and to some medications

Family history of kidney disease

High blood pressure (hypertension). High blood pressure causes another 30% of all kidney disease. Because blood pressure often rises with chronic kidney disease, high blood pressure may further damage kidney function even when another medical condition initially caused the disease.

How is it diagnosed?

The most common symptom of IgA nephropathy is blood in the urine, which causes the urine to look tea-colored. To confirm the diagnosis, a small piece of kidney tissue must be removed (biopsy) and examined.

Treatment of Chronic Kidney Disease

The goal of therapy is to slow down or halt the otherwise relentless progression of CKD to stage 5. Control of blood pressure and treatment of the original disease, whenever feasible, are the broad principles of management. Generally, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are used, as they have been found to slow the progression of CKD to stage 5

Initial treatment

One of the most important parts of treatment for chronic kidney disease is to control the disease that is causing it. If you have diabetes or high blood pressure, you and your doctor will develop a plan to aggressively treat and manage your condition to help slow additional damage to your kidneys.

If your child must take so much medicine that it affects his or her appetite, contact your doctor for advice. Try to find the most acceptable forms of medicine (smaller pills, capsules, or more concentrated liquids, for example) and simplify the medication schedule under your doctor\’s guidance.

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Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina is a symptom of a condition called myocardial ischemia. It occurs when the heart muscle (myocardium) doesn\’t get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart\’s arteries (blood vessels that supply blood to the heart muscle) is narrowed or blocked. Insufficient blood supply is called ischemia.

Causes

Decrease in myocardial blood supply due to increased coronary resistance in large and small coronary arteries

Significant coronary atherosclerotic lesion in the large epicardial coronary arteries (ie, conductive vessels) with at least a 50% reduction in arterial diameter

Coronary spasm (ie, Prinzmetal angina)

Symptoms of Angina Pectoris

Classic or typical angina occurs predictably with physical exertion or strong emotional reactions, and goes away just as predictably with rest. Starting immediately behind the sternum (breast bone), the pain may radiate to the left arm and shoulder or up to the jaw. Most people describe the pain as a kind of squeezing pressure, tightness or heaviness.

Angina Pectoris Treatment

The treatment for angina depends on the severity of the symptoms and the results of tests that are done to find the underlying cause.

Self-Care at Home

Stop doing whatever it is that causes your symptoms and call 911. Immediate help and intervention is your best chance for survival if you are having a heart attack or other serious problem.

* Lie down in a comfortable position with the head up.

* Chew a regular adult aspirin or its equivalent (as long as the patient is not allergic to aspirin). Chewing more than one will not do any good and may cause unwanted side effects.

* The bromide is sometimes of service in severe breast-pang. Thus, Papillaud relieved severe paroxysmal attacks by the use of 1/2 to 2 dr. doses continued \”at intervals\” for two or three months. In nervous palpitation it is often a very good remedy, and I have known it especially relieve gouty patients. Berger found bromide of camphor to answer well.

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What are the symptoms?

Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other diseases such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis. You should visit your doctor if you have these troubling symptoms.

If a doctor knows that the person already has diverticulosis, a diagnosis of diverticulitis may be based almost entirely on the symptoms. However, many other conditions involving the large intestine and other organs in the abdomen and pelvis can cause symptoms similar to diverticulitis, including appendicitis, colon or ovarian cancer, a pus-filled pocket of infection (abscess), and noncancerous growths on the wall of the uterus (uterine fibroids).

Diverticular bleeding occurs when the expanding diverticulum erodes into a blood vessel at the base of a diverticulum. Rectal passage of red, dark or maroon-colored blood and clots occur without any associated abdominal pain. Rarely, blood may be black from a diverticulum of the right colon. Bleeding may be continuous or intermittent, lasting several days.

Diverticulitis Causes

Diverticulosis is thought to be caused by increased pressure on the intestinal wall from inside the intestine.

As the body ages, the outer layer of the intestinal wall thickens. This causes the open space inside the intestine to narrow. Stool (feces) moves more slowly through the colon, increasing the pressure.

How is diverticulitis diagnosed?

Your doctor will ask about your symptoms and will examine you. He or she may do tests to see if you have an infection or to make sure that you don\’t have other problems. Tests may include:

Blood tests, such as a complete blood count (CBC).

Imaging tests, such as an X-ray, a CT scan, or a colonoscopy.

Treatment of Diverticulitis

An initial episode of acute diverticulitis is usually treated with conservative medical management, including bowel rest (ie, nothing by mouth), IV fluid resuscitation, and broad-spectrum antibiotics which cover anaerobic bacteria and gram-negative rods. However, recurring acute attacks or complications, such as peritonitis, abscess, or fistula may require surgery, either immediately or on an elective basis.

The involved portion of the colon may need to be removed with surgery if you have:

Abscess

Hole (perforation)

Fistula

Repeated attacks

After the acute infection has improved, diverticulitis is treated by increasing the bulk in the diet with high-fiber foods and bulk additives, such as psyllium.

Increased pressure in the colon can lead to breakdown of the wall of the diverticula leading to infection. A small tear or perforation can also develop in an infected pouch, which in turn can cause an infection within your abdomen (peritonitis). If the infection is limited to an area around the wall of your colon where the diverticula are inflamed, you may develop a localized collection of pus known as an abscess.

Initial treatment

Treatment for diverticulitis depends on the severity of your symptoms. If the pain is mild, you are able to drink liquids, and you have no signs of complications, treatment may include:

Medicines such as antibiotics and pain relievers.

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What causes dehydration?

Excessive loss of fluid through the intestinal tract can happen when the intestine is \”inflamed\” or damaged, or when bacteria or viruses cause the lining of the intestine to produce more fluid than can be absorbed.

Dieting can sap a person\’s water reserves as well. Beware of diets or supplements, including laxatives and diuretics that emphasize shedding \”water weight\” as a quick way to lose weight. Losing water weight is not the same thing as losing actual fat.

Dehydration often results from an illness, such as gastroenteritis, where you have persistent diarrhoea and vomiting. You can also become dehydrated after sweating excessively from a fever, heavy work in hot conditions or heatstroke.

Symptoms Of Dehydration

Mild to moderate dehydration is likely to cause:

Dry, sticky mouth

Sleepiness or tiredness — children are likely to be less active than usual

Thirst

Decreased urine output — fewer than six wet diapers a day for infants and eight hours or more without urination for older children and teens

Treatment Of Dehydration

Drinking fluids is usually sufficient for mild dehydration. It is better to have frequent, small amounts of fluid (using a teaspoon or syringe for an infant or child) rather than trying to force large amounts of fluid at one time. Drinking too much fluid at once can bring on more vomiting.

Prevention is better than cure. Adults should drink at least 6 glasses of fluids daily. Fluid intake should be increased on hot days. Exercise, fever, and hot weather increase the body\’s need for water. For mild dehydration, drinking plenty of water may be all that is needed. If electrolytes (especially sodium and potassium) are also lost, they must be replaced. Flavored sports drinks have been formulated to replace electrolytes lost during vigorous exercise.

Electrolyte solutions or freezer pops are especially effective. These are available at pharmacies. Sport drinks contain a lot of sugar and can cause or worsen diarrhea. In infants and children, avoid using water as the primary replacement fluid.

When to Seek Medical Care

Infants and small children can become dehydrated quickly.

Contact your doctor if your child has any of the following:

Dry mouth

Crying without tears

No urine output in four to six hours

If you take diuretics and develop diarrhea, you may need to stop taking the diuretic during the acute episode. Do not stop taking any medicine unless your doctor tells you to.

Use an oral rehydration solution. Unless your doctor advises otherwise, use an oral rehydration solution such as Pedialyte for infants and children who have diarrhea, vomiting or fever. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They also contain glucose or another carbohydrate such as rice powder to enhance absorption in the intestinal tract.

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Canker sores are also called aphthous (af-thus) ulcers. They are sores inside the mouth. You may have canker sores on the inside of your lips and cheeks, or on your gums or tongue. It is common to have more than one. They are painful but are not harmful. Usually, canker sores heal in 2 weeks. You may get them more than once.

Causes of Canker Sores

Doctors don\’t know exactly what causes canker sores. They may be hereditary, but doctors have not figured out exactly how people inherit the tendency to get them. Researchers think they may be an overreaction to the Streptococcus bacteria, because the bacteria are often found in the canker sore. People with canker sores often have small injuries from dental injections and toothbrushes in the lining of the mouth. Allergies, such as hay fever, are also associated with an increased risk for canker sores.

Canker sores often occur near the time of a menstrual period. They may also be brought on by stress – for example, many students get them during exams. Other possible causes include lack of cyanocobalamin (vitamin B12), folic acid, or iron. Certain foods may be triggers for canker sores or act as nutrients for the Streptococcus bacteria.

Canker Sore Symptoms

Canker sores occur in several forms. They can involve any area of the mouth except for the gums, lips, and hard palate.

Minor canker sores (which account for the majority of aphthous ulcers) are oval and less than 10 mm (1/3 inch) across. Most are 2-3 mm with a white center. They are painful but clear up within three to 14 days without scarring. It is unusual for them to become infected.

Major canker sores consist of deep ulcers measuring greater than 1 cm (1/3 inch). These ulcers, which are very painful, have irregular margins and often last for three to six weeks. They tend to heal with extensive scarring.

If you feel a burning or tingling sensation inside your mouth, canker sore might appear afterwards. It will start with a small whitish sore somewhat like a wound with red edges around it. Either it will appear under your tongue, inside your cheeks or on your tongue, canker sore starts with the same sensation and appearance. Other symptoms like swelling of lymph nodes, fever and listlessness could also be experienced though not related to canker sore.

Treatment of Canker Sores

Nutritional supplements. Your doctor is likely to prescribe a nutritional supplement if you\’re low in important nutrients, such as folate (folic acid), vitamins B-6, B-12 and zinc.

Pain from a canker sore generally lessens in a few days and the sores usually heal without treatment in about a week or two.

Avoid hot and spicy foods and foods with sharp crunchy edges, such as nacho chips, which can poke into the canker sore.

Topical pastes. Over-the-counter and prescription pastes such as Orabase, triamcinolone acetonide (Kenalog in Orabase), amlexanox (Aphthasol) and fluocinonide (Lidex) can help relieve pain and speed healing if applied to individual lesions as soon as they appear.

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A hiccup bout is any episode lasting more than a few minutes. If hiccups last longer than 48 hours, they are considered persistent or protracted. Hiccups lasting longer than one month are termed intractable. The longest recorded attack is 6 decades.

What causes hiccups?

Mild hiccups are a reaction to hot and spicy foods or too much alcohol. They may be caused by psychological or organic causes. Disease conditions that affect the kidney, chest, abdomen or heart can cause hiccups. The diaphragm may contract by stimulation either by impulses from the brain or by irritation anywhere along the vagus nerve. The vagus sends a signal to the phrenic nerve that sends the nerve impulse to the diaphragm. The diaphragm then goes into a sharp contraction causing the hiccup.

The vagus nerve impulse pattern in the throat causes spasms of the diaphragm which lead to a case of hiccups. By interrupting this pattern many people have success stopping hiccups. This is probably why very sweet or tart remedies seem to work well.

Symptoms

The characteristic sound of a hiccup, sometimes preceded by a small tightening sensation in your chest, abdomen or throat, are the only signs and symptoms associated with hiccups. People may have as few as four hiccups a minute or, rarely, as many as 60 hiccups a minute.

How are hiccups treated?

Most bouts of hiccups go away on their own within a few minutes to a few hours and do not require any treatment. Many home remedies are used to treat hiccups. Most of them involve increasing the level of carbon dioxide in the blood, which usually stops hiccups. Some of these remedies include:

* Holding your breath and counting slowly to 10.

* Breathing repeatedly into a paper bag for a limited period of time.

* Quickly drinking a glass of cold water.

Hiccups are usually not serious and require no medical attention. However, if the hiccups last for a long time (over three hours), occur with abdominal pain, interfere with your sleep or eating, or you start spitting up blood, you should definitely see a doctor.

Hiccups are treated medically only in severe and persistent (termed \”intractable\”) cases, such as in the case of a 15 year old girl who in 2007 hiccuped continuously for five weeks. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen, an anti-spasmodic, is sometimes required to suppress hiccups.

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]]> http://www.nmgmzbwg.com.cn/archives/5494/feed 0 http://www.nmgmzbwg.com.cn/archives/5418 http://www.nmgmzbwg.com.cn/archives/5418#comments Sat, 13 Mar 2010 12:45:00 +0000 admin http://www.nmgmzbwg.com.cn/archives/5418 A condition resulting from excessive intake of iron. Iron poisoning generally only occurs when too many iron supplements are taken – most cases involves children accidentally eating too many iron tablets. Iron poisoning can cause gastrointestinal ulcers, vomiting, diarrhea, liver damage and abdominal pain.

Generally iron poisoning occurs when a child takes 10 or more milligrams per 2.20 pounds (1 kg) of body weight. Thus a child weighing 60 pounds (27.21 kg) could easily suffer iron poisoning by ingesting 30 milligrams of iron. In adult pills, even a single pill, containing about 325 milligrams of iron could easily cause iron poisoning.

Self-Care at Home

If you have iron deficiency anemia, talk with your doctor about taking iron supplement pills and eating foods high in iron. You may be able to prevent iron deficiency anemia by following the recommended dietary allowance for iron. Iron-rich foods include meats (especially beef liver), eggs, and whole-grain or iron-fortified foods. Iron is also found in many foods including peas, beans, oatmeal, prunes, and figs.

If you suspect your child has accidentally swallowed iron tablets, call your doctor or poison control center immediately. You can locate your regional poison control center phone number before an emergency by checking the Web site of the American Association of Poison Control Centers.

* Do not attempt to induce vomiting, either manually or with syrup of ipecac. This will make it more difficult to assess whether your child is truly iron toxic.

* Bring the medicine containers along with you to the hospital.

* Once the doctor makes sure your child is breathing normally, the child likely will have his or her whole bowel cleaned by drinking a strong laxative fluid.

* Severe poisonings will require IV chelation therapy—a series of IVs containing deferoxamine mesylate (Desferal), a chemical that binds to iron in a cell and is then excreted in urine.

Dialysis

In medicine, dialysis is primarily used to provide an artificial replacement for lost kidney function due to renal failure. Dialysis may be used for very sick patients who have suddenly but temporarily, lost their kidney function or for quite stable patients who have permanently lost their kidney function. When healthy, the kidneys maintain the body\’s internal equilibrium of water and minerals and the kidneys remove from the blood the daily metabolic load of fixed hydrogen ions. The kidneys also function as a part of the endocrine system producing erythropoietin and 1, 25-dihydroxycholecalciferol. Dialysis treatments imperfectly replace some of these functions through the diffusion and convection. Dialysis is an imperfect treatment to replace kidney function because it does not correct the endocrine functions of the kidney.

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