INPUT ARTICLE: Article: This is important and is the opportunity to participate in important aspects of your child's care. Here's what you can do to make the process as smooth as possible:    Weight monitoring. Weight monitoring should be done as often as daily or every other day if frequent relapses continue to occur or treatment with high dose prednisone is ongoing. If your child's weight begins to increase quickly without explanation and while in remission, it may indicate the imminent onset of a relapse.  Keep track of medication and dosages. Medication lists can be very helpful, especially if kept in a notebook with "erasable" paper. Medication doses change frequently in those with SSNS and are easily confused or changes forgotten. This is an important safety measure.  Urine monitoring. Home monitoring of urine protein is easily done using a test strip — a thin plastic strip about 3 inches (7.6 cm) long and ¼ inch in diameter. These can be purchased in bottles of 50 and 100. Testing the first urine made in the morning is highly preferable. In remission, periodic urine checking may allow the early identification of an imminent or partial relapse. . This is a corticosteroid medication (frequently referred to as a "steroid"). Prednisone has several immunosuppressive properties and has been the mainstay of INS treatment for decades.  In addition to being the initial drug of choice for INS, it also is a strong predictive indicator of outcome.   Patients whose INS is, and remains, responsive to steroid treatment have high likelihoods of the disease eventually resolving. There are several corticosteroids closely related to prednisone that may be used as well. These are called prednisolone and methylprednisolone. For the initial episode of nephrotic syndrome, the recommended dose of oral prednisone is 2 milligrams per kilogram body weight (or 60 milligrams per square meter body surface area) per day.  Daily treatment continues for 4-6 weeks during which time most patients who will be steroid sensitive will have responded. Following this, most treatment protocols reduce the dose and give it every other day after which the dosage is slowly tapered. The total initial period of treatment is 4-8 months. The immunosuppressive effect of these drugs is primarily due to their interference with white blood cell chemical signaling that allows them to provide a coordinated immunological response. These were initially applied in kidney transplantation but have been used to treat INS for many years.   The drug names are cyclosporine and tacrolimus. These have become the most frequent second line treatment of choice as an alternative to prednisone. Side effects for both of these medications are risk of infection, and both are potentially toxic to the kidney and require careful monitoring.  Cyclosporine may cause abnormal hair growth (hirsutism) and tacrolimus, which rarely causes a diabetes mellitus-like condition. A disadvantage of treatment with these drugs is the need for periodic measurements of the blood level, which is used to determine the proper dose. This drug also provides immunosuppression by interfering with white blood cell growth.  Although serious infections may occur with MMF, they appear to be less frequent then with the alkylating agents.   Some patients must continue to take prednisone in combination with MMF to be effective. Therefore, those patients with serious steroid side effects may not benefit. Side effects are mostly gastrointestinal: cramps, diarrhea, and abdominal pain. For a treatment regimen, talk to your doctor. He or she will know what's appropriate for your child. These drugs were first used as cancer chemotherapy agents. They work by interfering with cell replication and therefore have the greatest effect on cells that are growing and dividing rapidly. This is why they are useful in many cancers.   Alkylating agents are principally used in patients who have SSNS with frequent relapses or severe corticosteroid side effects.  Today, they are rarely used in patients with steroid resistant nephrotic syndrome. Cyclophosphamide and chlorambucil are the most frequently used forms and are given orally. Treatment with oral cyclophosphamide is usually limited to three months with a total dose of approximately 180 milligram per kilogram body weight. This dose appears to minimize the risk of infertility. Principal serious side effects include increased risk of infection, infertility (dose-related), and severe bladder wall injury (hemorrhagic cystitis).  Temporary hair thinning or loss may also occur. Unfortunately, most patients will relapse at some point, at which time they are retreated with prednisone in a similar starting dose but with a somewhat more abbreviated total treatment period.   One of the greatest challenges of prednisone treatment (and especially starting it back up) is balancing benefit against side effects. There are numerous side effects (discussed above), whose risks increase with longer duration of therapy. There are several self-help publications that focus on managing mood swings and behavior changes, and appetite leading to obesity. They may help make everything more manageable. Unfortunately, with nephrotic syndrome, the complications practically outweigh the actual problem. Here are a few tactics to employ to ensure your child's health:   Do not end corticosteroid therapy abruptly unless specifically instructed by a physician. Write down the corticosteroid doses – they may change frequently and in potentially confusing ways. And be sure to keep up with prescription supply. Avoid contact with kids who are sick, in general.  Avoid chicken pox exposure if your child has not previously had chickenpox or the vaccine.  If there is exposure to chicken pox, or the appearance of shingles, contact your doctor promptly. Routine non-live virus vaccines should be given on a normal schedule including the annual influenza vaccination.  Give the pneumococcal vaccine.  Avoid live virus vaccines until, if possible, your child is off all immunosuppressive medications. Test for proteinuria frequently and report increased protein on first morning urine dipstick testing of 2+ (100 mg/dL) or greater on 2 consecutive days or if edema appears.

SUMMARY: Do active home monitoring. Have your child take prednisone Look into calcineurin inhibitors. Talk to your doctor about mycophenolate mofetil  (MMF). Consider starting on an alkylating agents. Know that most patients relapse. Work to minimize potential complications.


INPUT ARTICLE: Article: Pushing the cork down into the bottle is the easiest way to get to your drink, but it’s also the messiest to deal with. If your cork has broken and you can’t pull it out using other methods, you can always push it in.  Before you go pushing the cork into the bottle, make sure to remove any debris that you can from the cork. You will always end up with some, but try to make it easier on yourself and get rid of as much as possible. Make sure to do this somewhere you are ok with possibly wine or champagne squirting out of the bottle. You should not be wearing any clothing you like for this method. The pressure that you release when pushing the cork down into the bottle may cause some of the liquid to spray out. Using your fingers, push the cork down until it falls into the bottle. You will now have access to your drink, but there is also a cork and some debris in the wine or champagne. Quickly strain the liquid. After the cork lands in the bottle, use a coffee filter to strain out the residual cork pieces.  If you have a glass coffee pot like a Chemex with paper filters you can pour your wine from your bottle into the container. The filter will catch all the cork debris and let the liquid pass through. You can also use any paper filter over any type of container. You can rinse the bottle and pour the wine back in using a funnel. You may want to use another container, though. If most of the cork is still in the bottle, you can also just pour the wine into a decanter. Then, enjoy. Once you push a cork into a bottle, you won't be able to easily remove it. It's best to store your liquid in a new bottle.

SUMMARY:
Remove any debris from the cork. Push the cork into the bottle. Pour your wine through a coffee filter or strainer. Pour the wine into a new container.