Tinzaparin Provides Lower Lipid Profiles in Maintenance Hemodialysis Patients: A Cross-Sectional Observational Study

As a low-molecular-weight heparin, tinzaparin has effectively been used as an anticoagulant during hemodialysis sessions. However, the impact of different heparin types on dyslipidemia is still controversial. In our study, 434 chronic hemodialysis patients were evaluated. The mean age was 65 ± 13. Forty-eight patients (11%) and 386 patients (89%) were in the tinzaparin and unfractionated heparin (UFH) groups, respectively. Triglyceride had significant difference between the two groups (P=0.001) but total cholesterol, HDL, or LDL did not. In the univariate analysis, the triglyceride level was significantly associated with tinzaparin use [β: −39.9, 95% confidence interval (CI): −76.7 to −3.0], and this association remained following the multivariate analysis (β: −40.8, 95% CI: −75.1 to −6.5). The difference in serum total cholesterol level between tinzaparin and UFH became significant (β: −13, 95% CI: −24.5 to −1.56) after adjustment in the multivariate analysis. Moreover, in a subgroup analysis, male diabetic patients showed lower serum triglyceride levels with the use of tinzaparin, while older, nondiabetic, male patients showed significant advantages in total cholesterol levels with the use of tinzaparin. Based on our findings, tinzaparin shows a significant association with a lower lipid profile in patients with chronic hemodialysis when compared to UFH

Clinical Study Tinzaparin Provides Lower Lipid Profiles in Maintenance Hemodialysis Patients: A Cross-Sectional Observational Study

As a low-molecular-weight heparin, tinzaparin has effectively been used as an anticoagulant during hemodialysis sessions. However, the impact of different heparin types on dyslipidemia is still controversial. In our study, 434 chronic hemodialysis patients were evaluated. The mean age was 65 ± 13. Forty-eight patients (11%) and 386 patients (89%) were in the tinzaparin and unfractionated heparin (UFH) groups, respectively. Triglyceride had significant difference between the two groups ( = 0.001) but total cholesterol, HDL, or LDL did not. In the univariate analysis, the triglyceride level was significantly associated with tinzaparin use [ : −39.9, 95% confidence interval (CI): −76.7 to −3.0], and this association remained following the multivariate analysis ( : −40.8, 95% CI: −75.1 to −6.5). The difference in serum total cholesterol level between tinzaparin and UFH became significant ( : −13, 95% CI: −24.5 to −1.56) after adjustment in the multivariate analysis. Moreover, in a subgroup analysis, male diabetic patients showed lower serum triglyceride levels with the use of tinzaparin, while older, nondiabetic, male patients showed significant advantages in total cholesterol levels with the use of tinzaparin. Based on our findings, tinzaparin shows a significant association with a lower lipid profile in patients with chronic hemodialysis when compared to UFH

The Benefit Analysis of RFID Use in the Health Management Center – The Experience in Shin Kong Wu Ho-Su Memorial Hospital

隨著國人生活品質日益提升，對於自身健康狀況的掌握需求亦隨之增加，定期做健康檢查已成為瞭解自我健康狀況最便捷的方式。 然而，健康檢查往往十分的耗時與費事。在健檢過程中，最常聽到健檢來賓的抱怨，就是冗長的排隊等待時間。就以前作法，健檢來賓所要執行的檢查，都必須透過值班人員來掌握每一檢查室的進度，同時監控健檢來賓本身所要檢查的項目內容。而健檢來賓所要進行的檢查，並非侷限在一處，因此值班人員需費心費力地掌控每一環節，避免健檢來賓因等候時間過長造成身心俱疲的現象。同時，由於整個健檢流程都是採人工作業(從排程、健檢單、身分辨識等)，難免會有疏失的情況發生，並造成不必要的醫療錯誤。也由於健檢來賓可在院區內自由的活動，健檢中心的護理人員常常無法掌控健檢來賓動向，時常發生健檢來賓未準時到達檢查站之情況，造成醫護人員額外的負擔。除此之外，在診療過程當中，除了透過人工比對資料，並無法利用系統自動辨識健檢來賓的身分。 本研究以新光醫院為研究對象，導入RFID來打造全方位的預防醫學健檢中心，運用RFID為工具，發展相關的應用軟體，以提升健檢的效率同時減低人工調度的成本並提供醫療資訊分享、院際間資訊查詢，達成醫療資訊資源重複使用，所帶來效益不僅強化健檢中心服務品質並建立一個健康檢查中心標準作業流程的典範。 本研究效益不僅僅於作業流程的改造，在帶動外籍人士來台進行觀光健檢方面也大幅提升其競爭力，透過本研究將健檢中心的服務品質與效率提升，一定能夠帶動外籍人士來台進行觀光健檢With the rising quality of life for people, for their own health needs will also increase, regular health checks done on self-health status has become the most convenient way. However, the health check is often a very time-consuming and trouble. In the health check process, the most commonly heard guests complain about health examination is the long queue waiting time. On the previous practice, health testing, guests check to be performed, must be through the duty officer to master the progress of each examination room at the same time monitor the health examination and gentlemen, the project itself to check the contents. The health examination to be carried out by the guest check is not confined to one, so be on duty to control every aspect of trouble to avoid the health examination and gentlemen, due to long waiting times caused by thetired phenomenon of. At the same time, due to adopt the entire health check process is artificial work (from the scheduling, health slips, identity recognition, etc.), it is inevitable there will be at fault occur and result in unnecessary medical errors. Also because of health examinations guests can freely within the center district''s activities, health center nurses are often unable to control the health examination guests situation, health testing, frequent guests did not arrive at the checkpoint o, resulting in an additional burden on health care workers. In addition, in the treatment process, except through artificial identification, and access to health examination system to automatically recognize the identity of guests. In this study, Shin Kong Hospital, as the research object, import RFID to create a full range of preventive medicine health center on the use of RFID as a tool for development-related software applications to enhance the efficiency of health examination scheduling while reducing labor costs and provide medical information sharing , the hospital inter-information query, re-use of the medical information resources, which bring benefits not only to strengthen the health center on the quality of service and the establishment of a health center model of standard operating procedures. This study not only the operating effectiveness of the transformation process, in the lead foreigners to come to Taiwan for sightseeing, health check, are also greatly enhance their competitiveness, through this study health center''s service quality and efficiency gains, will be able to bring foreign nationals to come to Taiwan sightseeing health chec

An atypical presentation of high potassium renal secretion rate in a patient with thyrotoxic periodic paralysis: a case report

Abstract Background Hypokalemia is one of the most common clinical electrolyte imbalance problems, and thyrotoxic periodic paralysis (TPP) is a leading cause of presentation to the emergency department. Low renal potassium secretion rates, a normal acid–base balance in the blood, and hyperthyroidism are the hallmarks of suspected TPP. Case presentation Here we report the case of a 36-year-old man who presented to the emergency department with a sudden onset of acute muscle weakness at 5 h prior to admission. Biochemistry tests revealed hypokalemia with hyperthyroidism and renal potassium wasting. TPP was initially not favored due to the presence of renal potassium wasting. However, his serum potassium level rebounded rapidly within several hours after potassium supplementation, indicating that the intracellular shifting of potassium ions was the main etiology for his hypokalemia. The early stage of TPP development may have contributed to this paradox. Conclusion Therefore, it is premature to rule out TPP based on the presentation of high renal potassium secretion rates alone. This finding may result in an incorrect impression being made in the early stage of TTP and may consequently lead to an inappropriate potassium supplementation policy

Epigallocatechin-3-gallate combined with alpha lipoic acid attenuates high glucose-induced receptor for advanced glycation end products (RAGE) expression in human embryonic kidney cells

The anti-oxidant effects of epigallocatechin gallate (EGCG) and alpha lipoic acid (ALA) have been demonstrated in previous studies. The kidney protection effects of EGCG and ALA in patients with kidney injury are still under investigation. The purpose of this study is to investigate the anti-inflammatory and anti-oxidant effects of EGCG and ALA on high glucose-induced human kidney cell damage. EGCG inhibited high glucose(HG)-induced TNF-α and IL-6 production in human embryonic kidney (HEK) cells. Both EGCG and ALA decreased HG-induced receptor of advanced glycation end products (RAGE) mRNA and protein expressions in HEK cells. EGCG and ALA also recovered HG-inhibited superoxide dismutase production and decreased ROS expressions in HEK cells. The synergism of EGCG and ALA was also studied. The effect of EGCG combined with ALA is greater than the effect of EGCG alone in all anti-inflammation and anti-oxidant experiments. Our studies provide a potential therapeutic application of EGCG and ALA in preventing progression of diabetic nephropathy

Sites of peripheral artery occlusive disease as a predictor for all-cause and cardiovascular mortality in chronic hemodialysis.

The ankle-brachial blood pressure (BP) index (ABI) not only indicates the presence of peripheral artery occlusive disease (PAOD) but predicts mortality in patients undergoing hemodialysis (HD). However, whether the site of PAOD can provide additional contribution to predicting mortality have not been investigated yet. Our primary objective was to determine the associations between the site of PAOD and all-cause and cardiovascular mortality in chronic HD (CHD) patients.A retrospective cohort study was conducted to evaluate 444 Taiwanese CHD patients between December 2006 and June 2013. The site of PAOD together with other explanatory variables such as demographic data, body mass index, a history of cardiovascular diseases, HD vintage, biochemical data, and cardiothoracic ratio (CTR) were assessed by the Cox proportional hazards regression model.The frequency of PAOD was 14.6% in both legs, 4.9% in the right side only, and 5.1% in the left side only. During the study period, 127 all-cause and 93 cardiovascular deaths occurred. PAOD site was found to have significant predictive power for all-cause mortality with the order of 3.04 (95% CI: 1.56-5.90) hazard ratio on the right side, 2.48 (95% CI: 1.27-4.82) on the left side, and 4.11 (95% CI: 2.76-6.13) on both sides. The corresponding figures for cardiovascular mortality were 3.81 (95% CI: 1.87-7.76) on the right side, 2.76 (95% CI: 1.30-5.82) on the left side, and 3.95 (95% CI: 2.45-6.36) on both sides. After adjustment for other explanatory variables, only right-sided PAOD still remained to have significant predictive power for all-cause and cardiovascular mortality and bilateral PAOD kept the significant association with all-cause mortality.The site of PAOD revealed various predictive powers for all-cause and cardiovascular mortality in CHD patients and only right-sided PAOD remained an independent predictor for both types of mortality making allowance for relevant confounding factors