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Writing activity

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IRREGULAR VERBS

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Oxford University Press, English Language Teaching - elt.enquiry@oup.com

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Unit 7 - Exercise 1 - Past simple affirmative: irregular verbs | Solutions | Oxford University Press

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Students >Solutions >Elementary >Grammar >Unit 7 - Exercise 1 - Past simple affirmative: irregular verbs

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REGULAR VERBS

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English Exercises: 3 exercises (30 sentences) Past Simple regular verbs only

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past simple exercise. Past simple for beginners. 3 exercises using only regular verbs. Practice drill.

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"TELL ME ABOUT YOURSELF" https://youtu.be/U4k2Ym4PyQk

E "WHAT ARE YOUR WEAKNESSES" https://www.youtube.com/watch?v=7khSoRwcNVI

"TELL ME ABOUT YOUR GOALS"

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On line test- wizard

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Nós já postamos muitos conteúdos sobre diversos tempos verbais aqui no blog da Wizard, e depois de ver tanta coisa, só nos falta praticar, não é mesmo? Pensando nisso, nós preparamos alguns exercícios especiais para você colocar em prática tudo que aprendeu e identificar onde tem mais dificuldade.

E aí, como você se saiu? Ficou com alguma dúvida sobre os tempos verbais? Então entenda de maneira mais completa cada um deles com nossos posts:

Confie em quem é comprometido com o seu aprendizado e quer ver você vencer. Se você ainda não desistiu e quer se desafiar em um novo idioma, clique aqui e mergulhe na experiência Wizard. A gente acredita em você!

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EXERCÍCIOS DE INGLÊS SOBRE TEMPOS VERBAIS - Wizard Idiomas

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EXERCÍCIOS DE INGLÊS SOBRE TEMPOS VERBAIS

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Reading- skimming/scanning

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Introdução à gramática- verb tenses

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Exercises

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This Course Video Transcript

This is a course about addiction to drugs and other behaviors. It will describe what happens in the brain and how this information helps us deal with and overcome addiction. It will also discuss other topics, such as government policy and our vulnerability to take drugs.

View Syllabus

Skills You'll Learn

Prevention Programs, Addiction Treatment, Brain, Drug And Alcohol Abuse Treatment

The Background & Overview of Drug Use

In this first week, we'll explore drug abuse, types of addictions, and the behaviors associated with them.

Taught By

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Definitions and Terminology - The Background & Overview of Drug Use | Coursera

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This Course Video Transcript This is a course about addiction to drugs and other behaviors. It will describe what happens in the brain and how this information helps us deal with and overcome addiction. It will also discuss other topics, such as government policy and our vulnerability to take drugs.

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Introducing the Human Brain

The human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity-you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. The brain regulates your body's basic functions, enables you to interpret and respond to everything you experience, and shapes your behavior. In short, your brain is you -everything you think and feel, and who you are.

How does the brain work?

The brain is often likened to an incredibly complex and intricate computer. Instead of electrical circuits on the silicon chips that control our electronic devices, the brain consists of billions of cells, called neurons, which are organized into circuits and networks. Each neuron acts as a switch controlling the flow of information. If a neuron receives enough signals from other neurons that it is connected to, it fires, sending its own signal on to other neurons in the circuit.

The brain is made up of many parts with interconnected circuits that all work together as a team. Different brain circuits are responsible for coordinating and performing specific functions. Networks of neurons send signals back and forth to each other and among different parts of the brain, the spinal cord, and nerves in the rest of the body (the peripheral nervous system).

To send a message, a neuron releases a neurotransmitter into the gap (or synapse) between it and the next cell. The neurotransmitter crosses the synapse and attaches to receptors on the receiving neuron, like a key into a lock. This causes changes in the receiving cell. Other molecules called transporters recycle neurotransmitters (that is, bring them back into the neuron that released them), thereby limiting or shutting off the signal between neurons.

How do drugs work in the brain?

Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brain's own chemicals, they don't activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network.

Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons.

What parts of the brain are affected by drug use?

Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks addiction. Brain areas affected by drug use include:

The basal ganglia, which play an important role in positive forms of motivation, including the pleasurable effects of healthy activities like eating, socializing, and sex, and are also involved in the formation of habits and routines. These areas form a key node of what is sometimes called the brain's "reward circuit." Drugs over-activate this circuit, producing the euphoria of the drug high. But with repeated exposure, the circuit adapts to the presence of the drug, diminishing its sensitivity and making it hard to feel pleasure from anything besides the drug.

The extended amygdala plays a role in stressful feelings like anxiety, irritability, and unease, which characterize withdrawal after the drug high fades and thus motivates the person to seek the drug again. This circuit becomes increasingly sensitive with increased drug use. Over time, a person with substance use disorder uses drugs to get temporary relief from this discomfort rather than to get high.

The prefrontal cortex powers the ability to think, plan, solve problems, make decisions, and exert self-control over impulses. This is also the last part of the brain to mature, making teens most vulnerable. Shifting balance between this circuit and the circuits of the basal ganglia and extended amygdala make a person with a substance use disorder seek the drug compulsively with reduced impulse control.

Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.

How do drugs produce pleasure?

Simple activities in everyday life can produce small bursts of neurotransmitters in the brain bringing pleasurable feelings. Drugs can hijack that process.

Pleasure or euphoria-the high from drugs-is still poorly understood, but probably involves surges of chemical signaling compounds including the body's natural opioids (endorphins) and other neurotransmitters in parts of the basal ganglia (the reward circuit). When some drugs are taken, they can cause surges of these neurotransmitters much greater than the smaller bursts naturally produced in association with healthy rewards like eating, hearing or playing music, creative pursuits, or social interaction.

It was once thought that surges of the neurotransmitter dopamine produced by drugs directly caused the euphoria, but scientists now think dopamine has more to do with getting us to repeat pleasurable activities (reinforcement) than with producing pleasure directly.

How does dopamine reinforce drug use?

The feeling of pleasure is how a healthy brain identifies and reinforces beneficial behaviors, such as eating, socializing, and sex. Our brains are wired to increase the odds that we will repeat pleasurable activities. The neurotransmitter dopamine is central to this. Whenever the reward circuit is activated by a healthy,

pleasurable experience, a burst of dopamine signals that something important is happening that needs to be remembered. This dopamine signal causes changes in neural connectivity that make it easier to repeat the activity again and again without thinking about it, leading to the formation of habits.

Just as drugs produce intense euphoria, they also produce much larger surges of dopamine, powerfully reinforcing the connection between consumption of the drug, the resulting pleasure, and all the external cues linked to the experience. Large surges of dopamine "teach" the brain to seek drugs at the expense of other, healthier goals and activities.

Cues in a person's daily routine or environment that have become linked with drug use because of changes to the reward circuit can trigger uncontrollable cravings whenever the person is exposed to these cues, even if the drug itself is not available. This learned "reflex" can last a long time, even in people who haven't used drugs in many years. For example, people who have been drug free for a decade can experience cravings when returning to an old neighborhood or house where they used drugs. Like riding a bike, the brain remembers.

Why are drugs more addictive than natural rewards?

For the brain, the difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain of someone who misuses drugs adjusts by producing fewer neurotransmitters in the reward circuit, or by reducing the number of receptors that can receive signals. As a result, the person's ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.

This is why a person who misuses drugs eventually feels flat, without motivation, lifeless, and/or depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs to experience even a normal level of reward-which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar high-an effect known as tolerance.

Long-term drug use impairs brain functioning.

For more information on drugs and the brain, order NIDA's Teaching Addiction Science series or the Mind Matters series at www.drugabuse.gov/parent-teacher.html. These items and others are available to the public free of charge.

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Drugs and the Brain | National Institute on Drug Abuse

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The human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity-you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities.

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How Drugs Affect the Brain and Central Nervous System

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How Drugs Affect the Brain and Central Nervous System

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In simplest terms, the brain comprises a network of neurons to process and transmit information. Drugs and alcohol can interfere with the way these brain cells function, altering the way they send, receive, and process signals. ¹

Alcohol and/or drug use-including heavy and chronic use as well as processes involved in overdose and withdrawal-can impact a host of neurological and behavioral conditions. For example, substance use can alter feelings, perceptions, thought processes, and behavior. ² It can also lead to various conditions involving the central nervous system, including everything from headaches and stroke to seizures and cognitive disorders. ³ Plus, over time, substance use can even change the brain in ways that contribute to addiction development and make it more challenging to maintain abstinence. 4

That said, the severity and duration of these brain-related impacts vary considerably. While some effects can be persistent or even permanent, others may improve after a period of abstinence and appropriate medical attention, while still others disappear quickly with sobriety. ²

It's important to note that the relationship between substance misuse and various CNS conditions is often complicated by use of more than one substance and/or underlying health conditions. However, the following content provides an overview of some of the more common neurological conditions linked to substance misuse, along with insights about key substances associated with each.

Cognitive and Behavioral Disorders

Substance use has both immediate and long-term effects on brain networks that impact behavior, memory, and cognition. Shortly after use, effects can include altered consciousness, impaired memory, disinhibition, euphoria, inattention, altered judgement, and more. Meanwhile, long-term use can lead to impairments across multiple cognitive domains, including memory, attention, and executive function. Additionally, people can experience cognitive and behavioral issues that result from more indirect substance-related mechanisms, such as head trauma, infections, malnutrition, and combined polysubstance effects. ³

Common substances associated with cognitive and behavior dysfunction include:

Alcohol. Alcohol misuse can lead to several acute and chronic conditions including:

Wernicke-Korsakoff Syndrome. Wernicke-Korsakoff syndrome (WKS) is one condition comprising two different stages: Wernicke encephalopathy and Korsakoff syndrome.5,6 Caused by thiamine deficiency often seen with excessive alcohol consumption, Wernicke encephalopathy is an acute degenerative brain disorder that's considered a medical emergency.7 If Wernicke encephalopathy goes untreated, it can progress to Korsakoff syndrome-a long-lasting and potentially permanent memory disorder that can lead to coma and death.3,5,6,8

Pellagra. With symptoms including gastrointestinal lesions, rash, and neurobehavioral/cognitive symptoms (e.g., irritability, insomnia, dementia, delirium, delusions, hallucinations, and memory impairment), pellagra is a result of nicotinic acid deficiency, which can be related to chronic alcohol use and subsequently diminished nutrient absorption. While prompt treatment can lead to recovery within hours or days, untreated pellagra is fatal.³

Alcohol-related dementia. A form of progressive cognitive decline, alcohol-related dementia isn't attributed to other causes such as primary dementia and trauma.³

Benzodiazepines. Long-term benzodiazepine use can lead to significant cognitive impairments in: sensory processing, problem-solving, attention/concentration, motor control/performance, nonverbal, verbal, and working memory, etc.⁹ While many cognitive areas improve with abstinence, some people may experience more persistent cognitive impairment, even after benzodiazepine discontinuation.9,10

Amphetamines. Amphetamines can cause psychomotor agitation, pressured speech, and hyper-alertness. Plus, misuse may lead to changes in brain structure that can adversely impact mood regulation and increase the risk of certain psychiatric conditions including psychosis, anxiety, and mood disorders.3 Chronic amphetamine use is also associated with deficits of cognitive skills such as pattern recognition, verbal fluency, etc.¹²

Methamphetamine. Methamphetamine misuse can have adverse neurological effects and can lead to certain types of brain injury and cognitive impairments (e.g., memory, attention, and decision-making skills). Additional deficits include those related to memory, attention, and executive functions.¹³ Based on data from the National Institute on Drug Abuse (NIDA), long-term meth effects can also include psychosis (including hallucinations, paranoia, and repetitive motor activity) along with changes in brain structure and function, increased distractibility, aggressive or violent behavior, mood disturbances, and more.¹⁴

Heroin and other opioids. Opioid use is associated with deficits of strategic planning and decision-making, and chronic opioid use is linked to deficits of executive functioning.3,15 And according to a paper published in the journal, opioid use disorder is associated with various cognitive disorders that can endure even through abstinence.¹⁵ Research related to the specific impact of heroin (a type of opioid) on cognitive disorders has shown mixed results ranging from mild to moderate dysfunction. However, at least one study revealed significant heroin-related deficits in visual memory tasks, impulsivity, and risky decision-making.³

Inhalants. NIDA data reveals that the neurotoxic effects of prolonged inhalant misuse can lead to deficits in cognition, movement, vision, and hearing, with cognitive abnormalities ranging from mild impairment to severe dementia.¹⁶ In particular, toluene, which is found in several types of glue, paint, and solvents, is linked to central nervous system damage.³

Seizures

A result of both withdrawal and drug toxicity, seizures can be linked to multiple substances including:

MDMA. While MDMA is associated with an increased risk of seizures, hyponatremia (a situation of low blood-sodium levels) and excessive fluid intake are more commonly associated with MDMA-related seizures.³

Methamphetamine. Seizures associated with smoked methamphetamine are usually accompanied by hypertension, cardia arrhythmia, agitation, psychosis, and/or fever.³

PCP and hallucinogens. While seizures aren't an expected toxic result of hallucinogens, they may be experienced after high-dose use.³

Inhalants. Acute inhalant intoxication is associated with toxicity-related seizures.³

Stroke

Substance use can contribute to the development and progression of stroke, even in people without other vascular risk factors. More than 85% of strokes are ischemic strokes, which feature obstructed or reduced blood flow to the brain, which may then lead to a lack of oxygen and subsequent brain injury. ³ That said, the other type of stroke-i.e., hemorrhagic-may be more common in relation to some substances such as amphetamines. ¹⁷

Substances most associated with stroke include:

Alcohol. Based on data from a large, international study of stroke risk factors, moderate and high consumption of alcohol (i.e., 7 drinks or more per week) have been associated with an increased risk of stroke.¹⁸ Plus, heavy consumption can lead to complications (e.g., cardiac disease, platelet dysfunction, synthetic liver dysfunction, high blood pressure, accelerated atherosclerosis, and more) that then increase stroke risk.⁸

Cocaine. Cocaine increases the risk of several cardiovascular and cerebrovascular complications. It can lead to coronary artery vasoconstriction, hypertensive surges, inflammation of the arterial walls, and increased platelet aggregation-all of which can lead to various types of strokes. Additionally, a sharp rise in the prevalence of both ischemic and hemorrhagic stroke mirrors the introduction of crack cocaine in the '80s, suggesting that crack may increase stroke risk.³

Amphetamine. Various amphetamines (including methamphetamine) can cause excitability, heightened alertness, and euphoria in conjunction with increased sympathetic nervous system tone. This may in turn lead to a rise in blood pressure and heart rate, as well as instances of arrhythmia, vasospasm, and vasculitis. These factors can then increase the risk of stroke.³

MDMA. Within the setting of a hypertensive crisis and severe hyperthermia in association with MDMA, both hemorrhagic and ischemic strokes are possible.³

Heroin. Both hemorrhagic and ischemic strokes have been associated with heroin use. Potential mechanisms include direct toxicity, adulterants, overdose-related hypotension and respiratory depression with hypoxemia, and more. That said, injected and snorted heroin has caused stroke without the presence of other risk factors.³ Additionally, heroin use via injection is linked to a risk of various cerebrovascular complications, including both types of stroke.¹⁵

Hallucinogens. Severe hypertension caused by LSD can lead to vasoconstriction in systemic and cerebral arteries. This in turn can cause occlusion and narrowing of the intracranial vasculature, ultimately leading to ischemic stroke.³

Neuromuscular Disorders

Neuromuscular disorders affect the muscles, nerves, and spinal cord. When it comes to substance use, these disorders can be acute or chronic and can: be associated with substance-related nutritional deficiencies or a related inflammatory response, occur secondary to direct substance toxicity, or be caused by another mechanism. Additionally, those experiencing intoxication and withdrawal may fall asleep for prolonged periods of time in unusual positions, resulting in compression neuropathies. ³

Substances associated with neuromuscular disorders include:

Alcohol. A form of progressive neurological dysfunction associated with chronic alcohol exposure, alcoholic neuropathy is characterized by pain, burning, and tingling typically in the feet and legs.19,20 Additionally, chronic excessive alcohol use can lead to alcoholic myopathy, which can result in pain, weakness, tenderness, and swelling in the muscles near the body's midline.21,22 Chronic, heavy alcohol use is linked to progressive loss of muscle strength, and persistent drinking can lead to cardiomyopathy, which affects the heart muscle.³

Inhalants. "Glue-sniffers neuropathy" is a severe form of neuropathy that affects people who sniff N-hexane, a hydrocarbon typically found in glues and roofing materials. It can lead to a severe neurological condition featuring partial or complete paralysis. Additionally, sniffing nitrous oxide can lead to myelopathy, which is a type of spinal cord disorder.³

Movement Disorders

While some substances can directly lead to movement disorders, withdrawal from substances can also trigger them. Generally speaking, movement disorders are either hyperkinetic (featuring excessive or abnormal involuntary movements) or hypokinetic (characterized by slowed or reduced movements and a reduction in voluntary control). ³

Substances related to movement disorders include:

Cocaine. Cocaine can worsen existing movement-involved conditions, and it's associated with several hyperkinetic movement disorders such as posturing and muscle spasms, tremors, and abnormal involuntary movements that are sometimes referred to as "crack dancing." Cocaine intoxication is also associated with "punding behaviors," which are a series of repetitive, involuntary movements and behaviors that are purposeless and unique to each individual. Examples include repetitive sorting and arranging, continuous handwashing, counting and recounting, etc.³

Amphetamines. Acute intoxication with amphetamines such as meth and MDMA can result in tremor, acute involuntary muscle movements/spasms, worsening of tics, and various unpredictable, rhythmic, and repetitive motions (i.e., dyskinesias). Additionally, acute amphetamine intoxication is linked to punding, and amphetamine use is associated with teeth grinding/gnashing and jaw clenching (i.e., bruxism) and repetitive tongue protrusion.³

Traumatic Brain Injury

Thanks to related disinhibition, impulsivity, and impaired executive function, drug and alcohol use is often associated with risk-taking behaviors, the latter of which predispose people to injury and physical trauma such as automobile crashes, violence, falls, burns, etc. ²³ This trauma, then, can dramatically impact the spinal cord, brain, nerves, and more. ³

Alcohol is often implicated in traumatic brain injuries. In fact, insights from the Substance Abuse and Mental Health Services Administration reveals that up to 75% of patients with a traumatic brain injury tested positive for alcohol at the time of hospital admission, and approximately 50% were intoxicated. ²

However, any substance that creates mental cloudiness, disinhibition, and impaired functioning can be associated with trauma and traumatic brain injury. For example, one review indicated that a single dose of benzodiazepines can significantly impair driving performance. ²⁴ In fact, the risk of driving while on benzodiazepines is similar to the risk of driving with a blood alcohol content (BAC) between 0.050% and 0.079%. (Someone with a BAC of 0.08% is considered legally impaired and may be arrested for driving under the influence [DUI].) ²⁵ Similarly, MDMA decreases a person's ability to perceive and predict motion. So skilled and potentially complex tasks such as driving a motor vehicle can be impaired. 26

Treatment for Neurological Effects of Drug and Alcohol Misuse

While some central nervous system effects are permanent, others may lessen or resolve with medical and addiction treatment paired with abstinence. Long-term health improvements may benefit from treating both the underlying substance use disorder and the associated neurological conditions.

Treatment for drug and alcohol use disorders is tailored to the unique needs of each individual. The various levels of care include: ²⁷

American Addiction Centers treatment facilities provide the entire spectrum of care, and they're in-network with myriad insurance providers and scattered across the country for easy access. To explore AAC treatment options, contact an AAC admissions navigator at or complete the insurance verification form. Staff is available 24/7 to answer treatment questions, discuss payment options, and help you or a loved one take the first steps toward recovery today.
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Learn what alcohol and drugs do to your brain, and which substances are most commonly associated with neurological issues.

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NIDA.NIH.GOV | National Institute on Drug Abuse (NIDA)

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NIDA's mission is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health. NIDA is one of the National Institutes of Health.

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Medications for Opioid Overdose, Withdrawal & Addiction

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Medications for Opioid Overdose, Withdrawal & Addiction

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Medications for Opioid Use Disorder Infographic
This infographic shows the different types of medications prescribed for opioid overdose, withdrawal, and addiction.

Medications for opioid overdose, withdrawal, and addiction
Medications for opioid overdose, withdrawal, and addiction are safe, effective and save lives.

The National Institute on Drug Abuse supports research to develop new medicines and delivery systems to treat opioid use disorder and other substance use disorders, as well as other complications of substance use (including withdrawal and overdose), to help people choose treatments that are right for them.
FDA-approved medications for opioid addiction, overdose, and withdrawal work in various ways.

Opioid Receptor Agonist: Medications attach to opioid receptors in the brain to block withdrawal symptoms and cravings.

Opioid Receptor Partial Agonist: Medications attach to and partially activate opioid receptors in the brain to ease withdrawal symptoms and cravings.

Opioid Receptor Antagonist: Medications block activity of opioid receptors in the brain to prevent euphoric effects (the high) of opioids and alcohol and help reduce cravings.

Adrenergic Receptor Agonist: A medication that attaches to and activates adrenergic receptors in the brain and helps alleviate withdrawal symptoms.

Four cards show medications prescribed to reduce opioid use and cravings.

Methadone available in daily liquid or tablets. Brand names are Dolophine® and Methadose®. Generics are available.

Naltrexone available in a monthly injection. Brand name is Vivitrol®

Buprenorphine available in daily tablet or monthly injection. Brand name is Sublocade®. Generic tablets are available.

Buprenorphine/Naloxone is available in daily film that dissolves under the tongue or tablet. Brand names are Zubsolv® and Suboxone® and generics are available.

Lofexidine treats withdrawal symptoms and is a tablet taken as needed. Brand name is Lucemyra®.

Naloxone reverses overdose and is available as an emergency nasal spray or injection. Brand name is Narcan® and generics are available.

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Medications for Opioid Overdose, Withdrawal & Addiction | National Institute on Drug Abuse

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Medications for Opioid Use Disorder Infographic This infographic shows the different types of medications prescribed for opioid overdose, withdrawal, and addiction. Medications for opioid overdose, withdrawal, and addiction Medications for opioid overdose, withdrawal, and addiction are safe, effective and save lives.

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Teste de Listening no EASY

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COURSERA

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COURSERA

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COURSERA

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Diagnosis

As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits, and whether you have any family members who have kidney disease.

Next, your doctor performs a physical exam, also checking for signs of problems with your heart or blood vessels, and conducts a neurological exam.

For kidney disease diagnosis, you may also need certain tests and procedures, such as:

Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.

Urine tests. Analyzing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.

Imaging tests. Your doctor may use ultrasound to assess your kidneys' structure and size. Other imaging tests may be used in some cases.

Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem.

Treatment

Begin the process of becoming a living kidney or liver donor by clicking here to complete a Health History Questionnaire.

Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure.

Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease.

Treating the cause

Your doctor will work to slow or control the cause of your kidney disease. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled.

Treating complications

Kidney disease complications can be controlled to make you more comfortable. Treatments may include:

High blood pressure medications. People with kidney disease may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure - commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers - and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor will likely also recommend a water pill (diuretic) and a low-salt diet.

Medications to lower cholesterol levels. Your doctor may recommend medications called statins to lower your cholesterol. People with chronic kidney disease often experience high levels of bad cholesterol, which can increase the risk of heart disease.

Medications to treat anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia.

Medications to relieve swelling. People with chronic kidney disease may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.

Medications to protect your bones. Your doctor may prescribe calcium and vitamin D supplements to prevent weak bones and lower your risk of fracture. You may also take medication known as a phosphate binder to lower the amount of phosphate in your blood, and protect your blood vessels from damage by calcium deposits (calcification).

A lower protein diet to minimize waste products in your blood. As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys must do, your doctor may recommend eating less protein. Your doctor may also ask you to meet with a dietitian who can suggest ways to lower your protein intake while still eating a healthy diet.

Your doctor may recommend follow-up testing at regular intervals to see whether your kidney disease remains stable or progresses.

Treatment for end-stage kidney disease

If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant.

Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys can no longer do this. In hemodialysis, a machine filters waste and excess fluids from your blood. In peritoneal dialysis, a thin tube (catheter) inserted into your abdomen fills your abdominal cavity with a dialysis solution that absorbs waste and excess fluids. After a period of time, the dialysis solution drains from your body, carrying the waste with it.

Kidney transplant. A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors. You'll need to take medications for the rest of your life to keep your body from rejecting the new organ. You don't need to be on dialysis to have a kidney transplant.

For some who choose not to have dialysis or a kidney transplant, a third option is to treat kidney failure with conservative measures. However, once you have complete kidney failure, your life expectancy generally would be only a few months.

Potential future treatments

Regenerative medicine holds the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair.

Regenerative medicine approaches include:

Boosting the body's natural ability to heal itself

Using healthy cells, tissues or organs from a living or deceased donor to replace damaged ones

Delivering specific types of cells or cell products to diseased tissues or organs to restore tissue and organ function

For people with chronic kidney disease, regenerative medicine approaches may be developed in the future to help slow progression of the disease.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

As part of your treatment for chronic kidney disease, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Ask your doctor for a referral to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys.

Depending on your situation, kidney function and overall health, your dietitian may recommend that you:

Avoid products with added salt. Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses.

Choose lower potassium foods. Your dietitian may recommend that you choose lower potassium foods at each meal. High-potassium foods include bananas, oranges, potatoes, spinach and tomatoes. Examples of low-potassium foods include apples, cabbage, carrots, green beans, grapes and strawberries. Be aware that many salt substitutes contain potassium, so you generally should avoid them if you have kidney failure.

Limit the amount of protein you eat. Your dietitian will estimate the appropriate number of grams of protein you need each day and make recommendations based on that amount. High-protein foods include lean meats, eggs, milk, cheese and beans. Low-protein foods include vegetables, fruits, breads and cereals.

Coping and support

Receiving a diagnosis of chronic kidney disease can be worrisome. You may be concerned about what your diagnosis means for your future health. To help you cope with your feelings, consider trying to:

Connect with other people who have kidney disease. Other people with chronic kidney disease understand what you're feeling and can offer unique support. Ask your doctor about support groups in your area. Or contact organizations such as the American Association of Kidney Patients, the National Kidney Foundation or the American Kidney Fund for groups in your area.

Maintain your normal routine, when possible. Try to maintain a normal routine, doing the activities you enjoy and continuing to work, if your condition allows. This may help you cope with feelings of sadness or loss that you may experience after your diagnosis.

Be active most days of the week. With your doctor's advice, aim for at least 30 minutes of physical activity most days of the week. This can help you cope with fatigue and stress.

Talk with a person you trust. Living with chronic kidney disease can be stressful, and it may help to talk about your feelings. You may have a friend or family member who is a good listener. Or you may find it helpful to talk with a faith leader or someone else you trust. Ask your doctor for a referral to a social worker or counselor.

Preparing for your appointment

You'll likely start by seeing your primary care doctor if you have signs or symptoms of kidney disease. If lab tests reveal you have kidney damage, you may be referred to a doctor who specializes in kidney problems (nephrologist).

What you can do

To get ready for your appointment, ask if there's anything you need to do ahead of time, such as limit your diet. Then make a list of:

Your symptoms, including any that seem unrelated to your kidneys or urinary function

All your medications and doses, vitamins, or other supplements that you take

Your key medical history, including any other medical conditions

Questions to ask your doctor, listing the most important ones first in case time runs short

Take a family member or friend along, if possible. Sometimes it can be hard to remember everything you talked about with your doctor, and a relative or friend may hear something that you missed or forgot.

For chronic kidney disease, some basic questions to ask your doctor include:

What's the level of damage to my kidneys?

Is my kidney function worsening?

Do I need more tests?

What's causing my condition?

Can the damage to my kidneys be reversed?

What are my treatment options?

What are the potential side effects of each treatment?

I have these other health conditions. How can I best manage them together?

Do I need to eat a special diet?

Can you refer me to a dietitian who can help me plan my meals?

Should I see a specialist?

Is there a generic alternative to the medicine you're prescribing?

Are there any brochures or other printed material that I can have? What websites do you recommend?

How often do I need to have my kidney function tested?

Don't hesitate to ask any other questions during your appointment as they occur to you.

What to expect from your doctor

Your doctor may ask you questions, such as:

Are you experiencing any symptoms, such as changes in your urinary habits or unusual fatigue?

How long have you had symptoms?

Have you been diagnosed or treated for high blood pressure?

Have you noticed any changes in your urinary habits?

Does anyone in your family have kidney disease?

What medications are you currently taking? What doses?

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As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits, and whether you have any family members who have kidney disease.

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Text- simple present and present continuous

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Verb Tenses Explained, with Examples | Grammarly

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Verb tenses are changes or additions to verbs to show when the action took place: in the past, present, or future. The phrase is also used for grammatical aspects , which add more details about the duration or time an action takes. When you combine the four grammatical aspects with the past, present and future, you end up with twelve main verb tenses in English.

Verb tenses are essential for speaking English correctly, but with all the different forms and functions, they can get confusing. In this guide, we give a quick overview of the English tenses, including when to use them and how to make them, and give plenty of verb tense examples.

What is a verb tense?

Verb tenses show when an action took place, as well as how long it occurred. The main verb tenses are the past, present, and future.

There are also additional aspects that give extra details, such as the length of time the action occurred, which actions happened first, or whether a past action has an impact on the present. These grammatical aspects are the simple tense, perfect tense, continuous tense, and perfect continuous tense.

Verb tenses list: How many tenses are there in English?

The standard tense in English is the present tense, which is usually just the root form of the verb. The past and future tenses often require changes or additions to the root form, such as the - for the past tense and the for the future.

Past, present, and future tenses

The past, present, and future are the central divisions of time in English. The present represents actions happening now, while the past represents actions that happened earlier, and the future describes actions that will happen later.

Simple tense

The simple tense is a grammatical aspect that refers to the normal forms of the past, present, and future tenses-nothing fancy! Unlike the other aspects, it doesn't add any new information. True to its name, simple tenses are the easiest to form and have the fewest rules.

Perfect tense

The definition of the perfect tense is a little more complicated. It's used for actions that relate to other points in time, either completed or ongoing.

For example, in the sentence I have played soccer since I was a child , the perfect tense indicates that the action occurred continuously in the past and still happens in the present. By contrast, in the sentence I played soccer when I was a child , the simple past tense indicates that the action occurred only in the past, and has no relation to the present.

Continuous tense

We use the continuous tenses (also known as the progressive tenses) for ongoing actions or actions that happen a while before completion. For example, They are studying all night means the studying lasts many hours before it's finished.

Perfect continuous tense

When you combine the perfect and continuous tenses, you get the perfect continuous tense. It's typically used just like the perfect tense, except it describes ongoing actions that happen over a period of time.

English tenses examples: verb tenses chart

Past tenses

Simple past

Be careful of past tense verbs, however. These don't follow the normal rules and use their own unique forms for the past tense. For example, the past tense of the irregular verb is .

Past perfect

Past continuous

Use the past continuous to show an ongoing action in the past, especially if the action was interrupted by another action. It's also used for habitual actions that occurred in the past but not in the present. It's usually used with adverbs like or adverb phrases like all the time .

Past perfect continuous

The past perfect continuous tense is used just like the past perfect tense, except it describes ongoing actions that happened in the past instead of a one-time occurance. It's often used with the words , , and to connect it to another past action.

Present tenses

Simple present

Present perfect

an ongoing action started in the past that is not yet completed

the same action completed multiple times in the past and likely to be completed again

an uncompleted action that is expected to be finished (in the negative)

Additionally, the present perfect can be used to emphasize the significance of a completed action, especially one that happened over time.

Present continuous

Present perfect continuous

Future tenses

Simple future

Use the simple future for actions that have not happened yet but will later. To form the simple future, just place the modal verb before the root form of the main verb. (Note that if the action will happen in the near future, you can use the present continuous instead.)

Future perfect

Future continuous

Future perfect continuous

Verb tense FAQs

What are verb tenses?

Verb tenses are changes or additions to verbs to show when the action took place: in the past, present, or future. The phrase is also used for grammatical aspects, which show how long an action occurs.

What are the different types of verb tenses?

The three main verb tenses are the past, present, and future, but there are also four grammatical aspects: simple, continuous, perfect, and perfect continuous. When you combine the three time periods with the four aspects, you get twelve unique verb tenses.

What are some examples of the different verb tenses?

The simple tenses show actions happening at different times, while the perfect tenses show completed actions that relate to different time periods. The continuous tenses are for ongoing actions that take a while to complete. The perfect continuous tenses combine the perfect and continuous tenses to describe ongoing actions that happen over a period of time.

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Use this guide to learn how to use all tenses of a verb properly, including present perfect, past continuous, future perfect continuous, and more.

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Fill in the correct tense: Present Simple or Present Progressive

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Simple present & present continuous

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LISTENING - JOB HUNTING AND JOB INTERVIEW

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Correção - verb tenses

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LIAAS - Língua Inglesa Aplicada em Áreas da Saúde

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script Apresentação Jefferson.