QJM : monthly journal of the Association of Physicians
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Chronic disorders constitute a primary concern because of their burden on healthcare systems worldwide. Integrated care strategies enhancing the interface between tertiary care and primary care are pivotal to improve chronic care. ⋯ The study shows a high impact of cancer on planned hospitalizations whereas cardiovascular diseases and COPD generates a high percentage of unscheduled admissions. We conclude that integrated care services including patient-oriented guidelines are strongly needed to enhance both health and managerial outcomes.
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The following case of a young mother presenting with post-partum pulmonary oedema, highlights a singular and life-threatening complication of a common condition (thyrotoxicosis). While thyrotoxic heart disease is well described, thyrotoxic storm in the post-partum period associated with dilated cardiomyopathy, congestive cardiac failure and ventricular fibrillation is exceptional.
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Patients with diabetes have increased frequency of hospital admissions and longer lengths of stay compared to patients without diabetes. Our specialist diabetes inpatient service was reconfigured to deliver a proactive diabetes outreach service to improve the overall care of this population. ⋯ This reformatted service was associated with a marked improvement in a number of parameters relevant to inpatient care.
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Serum sodium has been shown to predict mortality in heart and liver failure. ⋯ The serum sodium is a powerful initial marker of likely mortality in unselected general medical patients. The increased death rate in hyponatraemic patients is independent of other clinical variables, whereas mortality in the hypernatraemic group is primarily a factor of illness severity.