When the serum creatinine increased to 2.2 mg/dL, a second kidney biopsy was performed 12 months after the first presentation, revealing isolated double contours and prominent FSGS with hyalinosis.
A complete blood count at presentation revealed a hemoglobin of 10.4 mg/dL, white cell count of 18 × 103 cell/μL with neutrophilia, and a platelet count of 660 × 10cell/μL.
Repeat cardiac studies using pulse contour cardiac output 12 hours after the initial presentation revealed a worsening cardiac index (2.5 l/min per m), with a reduced stroke volume of 30 ml and an increased systemic vascular resistance index of 2359, indicating the presence of a vasoconstricted low output state.
The audience Q. & A. after the presentation revealed a couple of problems, however.
The PowerPoint presentation reveals a clear link between hydraulic fracturing ("fracking") for shale gas in Dimock and groundwater contamination, but was censored by the Obama Administration.
Further work-up of the patient's initial feverish presentation revealed a pneumonia, which was treated successfully with antibiotics.
An MRI of the thoracic spine, performed at the time of presentation, revealed an irregular mass-like density predominantly at the T1 and T2 levels, with a hyper-intense and serpiginous contour demonstrated in the epidural space.
Results: A review of 45 patients at presentation revealed statistically significant reductions in quality of life as measured by each survey.
However, proteinuria was unabated on maximal conventional anti-proteinuric treatment, and a repeat renal biopsy 11 months after presentation revealed severe chronic changes.
The course is shown in Figure 2. A further renal biopsy taken 11 months after presentation revealed chronicity with 2 of 19 glomeruli completely and 7 partially sclerosed, tubular and interstitial changes with 50% atrophy and fibrosis.
That presentation reveals the principal obstacle to the argument's being convincing to a contemporary audience, namely, its apparent reliance on Kant's prohibition against psychological laws governing mental states.
