BMJ : British medical journal
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To examine the relation between deprivation and acute emergency admissions for cancers of the colon, rectum, lung, and breast in south east England. ⋯ Earlier diagnostic and referral procedures in primary care in deprived areas are required if there are to be significant reductions in mortality from these cancers. A national information strategy is required to ensure the continued availability of population based data on NHS patients and to mandate standardised datasets from the private sector. Rationalisation of acute services, hospital mergers, and plans for bed closures must take into account the increased healthcare needs and inequities in access to treatment and care of residents in areas with high levels of deprivation. Health authorities and primary care groups should re-examine their purchasing intentions, service reviews, and monitoring arrangements in the light of these findings.
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Meta Analysis
Human albumin administration in critically ill patients: systematic review of randomised controlled trials.
To quantify effect on mortality of administering human albumin or plasma protein fraction during management of critically ill patients. ⋯ There is no evidence that albumin administration reduces mortality in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality. These data suggest that use of human albumin in critically ill patients should be urgently reviewed and that it should not be used outside the context of rigorously conducted, randomised controlled trials.