Internal and emergency medicine
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The present study investigates the incidence of perioperative hyperkalemia and the influence factors of serum potassium levels during and after parathyroidectomy (PTX) in hemodialysis patients with renal hyperparathyroidism (rHPT). A total of 204 hemodialysis patients with refractory rHPT undergoing successful total parathyroidectomy with autotransplantation (tPTX + AT) were analyzed retrospectively. Hyperkalemia was defined as serum potassium levels ≥ 5.5 mmol/L. ⋯ K base+ was the only influencing factor for K d0+. Serum K base+ , preoperative serum alkaline phosphatase, and total calcium supplement dosage during intravenous calcium supplement were the influencing factors for K d3+. In the case of PTX, the serum potassium levels of patients with higher serum K base+ and severe postoperative hypocalcemia need to be monitored with extended attention perioperatively.
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The relation between philosophy and biomedicine has been reassessed and rethought in the last few years: on the one hand, philosophy of science has paid increasing attention to actual modes of biomedical research and clinical practice; on the other, classes in philosophy, and more generally, in the humanities, have started entering medical curricula. However, the role of philosophy in medical education is not yet unanimously recognized, with situations differing significantly in various national and international contexts. In line with the tradition in Italy and other countries of reflecting on clinical methodology and with the recent initiatives at the crossroads between medicine and philosophy, this contribution aims to argue for the mutual relevance of medicine and philosophy in educational processes, and to suggest some possible forms of implementation of their interactions.
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We investigated the adverse renal outcomes in patients affected by either atrial fibrillation (Afib) or atrial flutter (AFL). Using the Taiwan National Health Insurance research database, both cohorts were 1:1 propensity score matched based on age, sex, index year, and comorbidity using logistic regression model. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of acute kidney injury (AKI), chronic kidney disease (CKD), and end-stage renal disease (ESRD) between the two cohorts were obtained using Cox proportional hazard regression models. ⋯ Afib patients were 1.08 times (95% CI = 1.01-1.16) more likely to have AKI than AFL patients after adjusting for confounding covariates. Competing risk analysis showed that Afib patients were 1.08 (95% CI = 1.01-1.15), 1.18 (95% CI = 1.07-1.30) and 1.32 (95% CI = 1.12-1.55) times more likely to experience AKI, CKD and ESRD than AFL subjects. This study showed that Afib conferred worse renal events of AKI, CKD and ESRD than AFL.