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BMJ (Clinical Research Ed.) Jan 2009To assess the effectiveness of acute geriatric units compared with conventional care units in adults aged 65 or more admitted to hospital for acute medical disorders. (Meta-Analysis)
Meta-Analysis Review
Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis.
OBJECTIVE
To assess the effectiveness of acute geriatric units compared with conventional care units in adults aged 65 or more admitted to hospital for acute medical disorders.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Medline, Embase, and the Cochrane Library up to 31 August 2008, and references from published literature. Review methods Randomised trials, non-randomised trials, and case-control studies were included. Exclusions were studies based on administrative databases, those that assessed care for a single disorder, those that evaluated acute and subacute care units, and those in which patients were admitted to the acute geriatric unit after three or more days of being admitted to hospital. Two investigators independently selected the studies and extracted the data.
RESULTS
11 studies were included of which five were randomised trials, four non-randomised trials, and two case-control studies. The randomised trials showed that compared with older people admitted to conventional care units those admitted to acute geriatric units had a lower risk of functional decline at discharge (combined odds ratio 0.82, 95% confidence interval 0.68 to 0.99) and were more likely to live at home after discharge (1.30, 1.11 to 1.52), with no differences in case fatality (0.83, 0.60 to 1.14). The global analysis of all studies, including non-randomised trials, showed similar results.
CONCLUSIONS
Care of people aged 65 or more with acute medical disorders in acute geriatric units produces a functional benefit compared with conventional hospital care, and increases the likelihood of living at home after discharge.
Topics: Activities of Daily Living; Acute Disease; Aged; Case-Control Studies; Costs and Cost Analysis; Geriatrics; Home Nursing; Homes for the Aged; Hospital Units; Hospitalization; Humans; Prognosis; Quality Assurance, Health Care; Randomized Controlled Trials as Topic
PubMed: 19164393
DOI: 10.1136/bmj.b50 -
European Journal of Internal Medicine Aug 2011
Review
Topics: Acute Disease; Humans; Intensive Care Units; Internal Medicine
PubMed: 21767748
DOI: 10.1016/j.ejim.2011.05.017 -
International Journal of Antimicrobial... May 1998The diagnosis and management of prostatitis syndromes is a challenge to the clinician. Careful history and examination of the prostate fluid and quantitative segmented...
The diagnosis and management of prostatitis syndromes is a challenge to the clinician. Careful history and examination of the prostate fluid and quantitative segmented bacteriologic cultures will lead to proper categorization into the recognized forms of the prostatitis syndrome. Antimicrobial therapy is effective in the majority of men with acute and chronic bacterial prostatitis (CBP). Fluoroquinolone agents appear to have an increasingly important role in this regard, although a randomized, prospective, double-blind study is still lacking. Alpha-1-selective blocking agents may relieve symptomatology of chronic pelvis pain syndrome (CPPS). Other non-prostatic sources of voiding symptoms should be sought and ruled out, especially malignancy or inflammatory disorders.
Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Diagnostic Techniques, Urological; Humans; Male; Middle Aged; Pelvic Pain; Prostatitis
PubMed: 9716292
DOI: 10.1016/s0924-8579(98)00029-6 -
Current Opinion in Gastroenterology Mar 2020The current review discusses current practices regarding appropriate indications for parenteral nutrition in acutely ill hospitalized patients. We address-specific... (Review)
Review
PURPOSE OF REVIEW
The current review discusses current practices regarding appropriate indications for parenteral nutrition in acutely ill hospitalized patients. We address-specific indications for parenteral nutrition in the perioperative period, and in inflammatory bowel disease, oncology, hepatobiliary, critical care and end-stage renal disease patients.
RECENT FINDINGS
Acutely ill hospitalized patients can develop intestinal failure requiring parenteral nutrition. Recent studies have provided insight into the main indications. The most common indications for inpatient parenteral nutrition include postsurgical complications, including prolonged ileus, sepsis, fistula and leaks, and bowel obstruction, predominantly malignant. Severe or complicated inflammatory bowel disease and cancer treatment-related mucosal enteropathies (mucositis, enterocolitis, gut graft-versus-host disease) are the next commonest indications. Less frequent indications are primary motility disorders and inability to secure enteral access for enteral nutrition. Gastrointestinal failure of the intensive care patient is a separate entity resulting from multiple mechanisms, including an enteropathy and dysmotility.
SUMMARY
Despite the wider availability of nutrition support teams, use of parenteral nutrition is not without risk. The risks and benefits of parenteral nutrition in the acute setting need to be carefully considered even when it is indicated.
Topics: Acute Disease; Hospitalization; Humans; Nutritional Support; Parenteral Nutrition; Time Factors
PubMed: 31895227
DOI: 10.1097/MOG.0000000000000615 -
Annals of Emergency Medicine Nov 2012
Topics: Acute Disease; Emergency Service, Hospital; Female; Humans; Male
PubMed: 22762907
DOI: 10.1016/j.annemergmed.2012.06.005 -
The British Journal of General Practice... Jun 2009
Topics: Acute Disease; Family Practice; House Calls; Humans; Nurse Practitioners; Nurse's Role
PubMed: 19520031
DOI: 10.3399/bjgp09X420996 -
The British Journal of General Practice... Oct 2010
Topics: Acute Disease; Family Practice; Humans; Quality of Health Care
PubMed: 20883619
DOI: 10.3399/bjgp10X515656 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Feb 2016
Topics: Acupuncture Therapy; Acute Disease; Humans; Male; Middle Aged; Spasm; Stomach Diseases
PubMed: 27348922
DOI: No ID Found -
Proceedings. Symposium on Computer... 1991This paper addresses the nature of the prior probabilities of diseases for probabilistic diagnostic reasoning. Because diseases differ in their chronicity, occurrence,...
This paper addresses the nature of the prior probabilities of diseases for probabilistic diagnostic reasoning. Because diseases differ in their chronicity, occurrence, reoccurrence, and likelihood of becoming part of the patient population, reasoning in terms of the frequency of disease episodes is necessary to capture the important distinctions. Even with these complexities, it is possible to formulate a reasonably accurate, computationally tractable, frequency estimation method for combinations of diseases. This method also suggests ways in which the needed numbers can be estimated from patient data.
Topics: Acute Disease; Chronic Disease; Comorbidity; Diagnosis, Computer-Assisted; Probability
PubMed: 1807676
DOI: No ID Found -
AACN Clinical Issues Feb 1997In 1961, Heinlein described a "stranger" from another planet struggling to comprehend and integrate the cultural idiosyncracies of earthlings in his adopted land. One... (Review)
Review
In 1961, Heinlein described a "stranger" from another planet struggling to comprehend and integrate the cultural idiosyncracies of earthlings in his adopted land. One could compare that situation with what confronts acute-care nurse practitioners (ACNPs) as they embark into the practitioner's world of acute care. Rather than embrace the expensive and fragmented patient-care world through collaboration with its "strangers," ACNPs would benefit from clinging to elements of their own native nursing culture and become "nesters" rather than "perchers" in the quest for improved health care.
Topics: Acute Disease; Humans; Managed Care Programs; Nurse Practitioners; Workforce
PubMed: 9086922
DOI: 10.1097/00044067-199702000-00012