Colonial literature[ edit ] Because of the large immigration to Boston in the s, the articulation of Puritan ideals, and the early establishment of a college and a printing press in Cambridgethe New England colonies have often been regarded as the center of early American literature.
Signs and symptoms[ edit ] Diagram showing the typical location of renal colicbelow the rib cage to just above the pelvis The hallmark of a stone that obstructs the ureter or renal pelvis is excruciating, intermittent pain that radiates from the flank to the groin or to the inner thigh.
It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the ureter as it attempts to expel the stone.
Risk factors[ edit ] Dehydration from low fluid intake is a major factor in stone formation. High dietary intake of animal protein sodiumsugars including honey, refined sugarsfructose and high fructose corn syrup oxalate grapefruit juiceand apple juice may increase the risk of kidney stone formation.
This is typically done with a hour urine collection. The urine is analyzed for features that promote stone formation. In the United States, kidney stone formation was used as an indicator of excess calcium intake by the Reference Daily Intake committee for calcium in adults.
As the amount of calcium intake decreases, the amount Brief survey of american literature oxalate available for absorption into the bloodstream increases; this oxalate is then excreted in greater amounts into the urine by the kidneys. In the urine, oxalate is a very strong promoter of calcium oxalate precipitation—about 15 times stronger than calcium.
A study found that diets low in calcium are associated with a higher overall risk for kidney stone formation. For example, by increasing urinary calcium excretion, high dietary sodium may increase the risk of stone formation. Magnesium inhibits stone formation. Consumption of animal protein creates an acid load that increases urinary excretion of calcium and uric acid and reduced citrate.
Urinary excretion of excess sulfurous amino acids e. Excessive vitamin D supplementation may increase the risk of stone formation by increasing the intestinal absorption of calcium; correction of a deficiency does not.
However, some people have theorized that certain behaviors associated with frequent and binge drinking can lead to dehydration, which can, in turn, lead to the development of kidney stones.
Staghorn kidney stones are considerably larger. Calcium and oxalate come together to make the crystal nucleus. Supersaturation promotes their combination as does inhibition.
Continued deposition at the renal papillae leads to the growth of the kidney stones. Kidney stones grow and collect debris. In the case where the kidney stones block all routes to the renal papillae, this can cause severe discomfort.
The complete staghorn stone forms and retention occurs.
Smaller solids that break off can become trapped in the urinary glands causing discomfort. Displaced stones travel through the ureter.
If they cannot be broken down, they must be physically removed by a surgeon. The protective role of citrate is linked to several mechanisms; in fact, citrate reduces urinary supersaturation of calcium salts by forming soluble complexes with calcium ions and by inhibiting crystal growth and aggregation.
The therapy with potassium citrate, or magnesium potassium citrate, is commonly prescribed in clinical practice in order to increase urinary citrate and to reduce stone formation rates. Adhering to cells on the surface of a renal papillaa seed crystal can grow and aggregate into an organized mass.
Depending on the chemical composition of the crystal, the stone-forming process may proceed more rapidly when the urine pH is unusually high or low.
For example, at a pH of 7. Reducing the pH to 5. The formation of uric-acid stones requires a combination of hyperuricosuria high urine uric-acid levels and low urine pH; hyperuricosuria alone is not associated with uric-acid stone formation if the urine pH is alkaline.
Other endogenous inhibitors include calgranulin an S calcium-binding proteinTamm—Horsfall proteinglycosaminoglycansuropontin a form of osteopontinnephrocalcin an acidic glycoproteinpro thrombin F1 peptide, and bikunin uronic acid-rich protein.
The biochemical mechanisms of action of these substances have not yet been thoroughly elucidated.The PowerPoint PPT presentation: "Brief Survey of American Literature" is the property of its rightful owner.
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Please review the FAQs and contact us if you find a problem. Credits: 1 Recommended: 10th, 11th, 12th (This is typically the 11th grade course.) Prerequisite: Literature. These are some of the many databases available to you as a member of Middletown Thrall Library: Artemis (now Gale Literary Sources) Searches the following databases (described below): Literature Criticism Online, Literature for Students, Literature Resource Center, and Something about the Author.
A brief guide to American Literary Periods, including the Colonial, Renaissance, Beat, and Contemporary, along with examples. A Brief Overview of American Literary Periods. Search the site GO.
Literature. This era in American Literature is responsible for notable first works. Literature survey on S-Box Design. A Ciphers By Ritter page. -- Kam and Davida Kam, J. and G. Davida. Structured Design of Substitution-Permutation Encryption Networks. The course is a chronological--and necessarily highly selective--survey of English literature and highlights writers and texts from five general periods in English literary history: The Old English Period (c.
), weeks ; Able to develop and write brief, well-developed, and tightly focused literary analyses. Top: Text.