International journal of clinical practice
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Int. J. Clin. Pract. · Jul 2012
Multicenter Study Comparative StudyA dual-centre, cohort comparison of open, laparoscopic and robotic-assisted radical cystectomy.
The role of minimally invasive radical cystectomy as opposed to open surgery for bladder cancer is not yet established. We present comparative outcomes of open, laparoscopic and robotic-assisted radical cystectomy ⋯ Despite study limitations, RARC had the lowest transfusion and complication rates and the shortest length of stay, although taking the longest to perform.
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Diabetes mellitus is a risk factor for the development of coronary artery disease and chronic heart failure. When carefully screened for, diabetes or prediabetic disorders, are present in the majority of patients with clinically manifest ischaemic heart disease, and confer a major adverse impact upon morbidity and mortality. ⋯ However, despite optimal management, aided by recent landmark trials solely recruiting patients with diabetes, outcomes for patients with diabetes and heart disease remain poor. This review outlines the epidemiology, pathogenesis and management of diabetic heart disease, along with highlighting the many gaps in the evidence-base and suggesting future research priorities.
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Int. J. Clin. Pract. · Jul 2012
First interim analysis of the GIDEON (Global Investigation of therapeutic decisions in hepatocellular carcinoma and of its treatment with sorafeNib) non-interventional study.
Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib (GIDEON), a global, non-interventional, surveillance study, aims to evaluate the safety of sorafenib in all patients with unresectable hepatocellular carcinoma (uHCC) under real-life practice conditions, particularly Child-Pugh B patients, who were not well represented in clinical trials. ⋯ The GIDEON study is generating a large, robust database from a broad population of patients with uHCC. First interim analyses have shown global and regional differences in patient characteristics, disease aetiology and practice patterns. Subsequent planned analyses will allow further evaluation of early trends.
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Int. J. Clin. Pract. · Jul 2012
Implementation of sepsis management guideline in a community-based teaching hospital - can education be potentially beneficial for septic patients?
To assess clinical outcomes associated with the implementation of the sepsis management guideline in a community-based hospital. In addition, evaluate the utility and effectiveness of a Sepsis Education Program. ⋯ In a community based teaching hospital, implementing the surviving sepsis campaign guideline through an education programme was feasible and resulted in early therapy with aggressive fluid administration and appropriate antibiotics. The Sepsis Education Program resulted in early therapeutic interventions and contributed to the survival benefits.
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Int. J. Clin. Pract. · Jul 2012
Editorial CommentRobotic assisted radical cystectomy and urinary diversion.