Clinical medicine (London, England)
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Around 3 million people in the UK have chronic kidney disease and 20% of hospital admissions are complicated by acute kidney injury. Decline in kidney function is not a diagnosis; it is essential to identify and treat underlying causes of acute and chronic kidney disease to either achieve recovery or slow the decline of kidney function. ⋯ The procedure is invasive and not without risk, which although small has the potential to be both organ- and life-threatening. This review outlines roles of kidney biopsy for the non-specialist, with focus of its role in patients with diabetes, lupus, myeloma and in the older patient.
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Leptospirosis is one of the most important zoonotic bacterial diseases worldwide, commonly affecting resource-poor populations and resulting in significant morbidity and mortality. This article provides an overview of the epidemiology, clinical manifestations, diagnosis and treatment of human leptospirosis.
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In the context of an ageing population, many healthcare professionals have limited experience and confidence in having necessary advance care planning (ACP) conversations. ⋯ Multidisciplinary simulation training is an effective way to teach ACP to doctors, nurses and allied healthcare professionals. The simulation was shown to improve participant understanding, confidence and reduce barriers to discussions, both immediately and 3 months later.