International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2020
Multicenter StudyInter-hospital Variation in Surgical Intensity for Trauma Admissions: A Multicenter Cohort Study.
Guidelines for injury care are increasingly moving away from surgical management towards less invasive procedures but there is a knowledge gap on how these recommendations are influencing practice. We aimed to assess inter-hospital variation in surgical intensity for injury admissions and evaluate the correlation between hospital surgical intensity and mortality/complications. ⋯ Results should be interpreted with caution as they may be a result of residual confounding. However, they may suggest that there are opportunities for quality improvement in surgical care for injury admissions, particularly for orthopaedic injuries. Moving forward, we should aim to prospectively evaluate adherence to guidelines on non-operative management and their impact on mortality and morbidity.
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Int. J. Clin. Pract. · Nov 2020
Observational StudyMonocentric single-arm study of desmopressin acetate efficacy on nocturnal polyuria in the elderly.
We designed a retrospective, monocentric, observational study to assess the efficacy and short-term side effect profile of desmopressin, a synthetic analogue of antidiuretic hormone, in 42 elderly patients affected by nocturnal polyuria (NP), a subset of nocturia (nocturnal overproduction of urine at night), which is characterised by nocturnal urine volume (NVU) exceeding 33% of the 24-hours total urine output. ⋯ Our findings show efficacy of desmopressin in the elderly for NP treatment supporting further clinical trials in larger cohorts of patients.
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More than 70 million people worldwide are affected by developmental stuttering. It is important to reach out to the public, scientific and medical communities, and those who stutter with a goal to raise awareness about stuttering. In this short perspective, we argue that to educate, advocate, and spread awareness about stuttering, we need role models, support, and opportunities.
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Int. J. Clin. Pract. · Nov 2020
Early differentiation between uncomplicated and complicated Staphylococcus aureus bacteraemia: potential value and limitations of a clinical risk score.
A cornerstone in the management of Staphylococcus aureus bacteraemia (SAB) is the differentiation between a complicated and an uncomplicated SAB course. The ability to early and accurately identify patients with - and without - complicated bacteraemia may optimise the utility of diagnostics and prevent unnecessary prolonged antibiotic therapy. ⋯ The early SAB risk score helps to identify patients with high probability of uncomplicated SAB. However, the risk score's lacked absolute discriminative power to guide decisions on the management of all patients with SAB on its own. The heterogenicity of the disease and inconsistency in definitions of complicated SAB are important challenges in the development of clinical rules to guide the management of SAB.
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Int. J. Clin. Pract. · Nov 2020
Diagnostic performance of Transrectal ultrasound for Prostate volume estimation in Men with Benign Prostate Hyperplasia.
Despite transrectal ultrasound (TRUS) being regarded as gold standard for prostate volume estimation, concerns have been raised in the literature concerning its accuracy especially in men with above-average prostate volumes. We aimed to evaluate the performance of TRUS for prostate volume estimation in a cohort of sub-Saharan African men since they are known to have relatively large mean prostate volumes. ⋯ TRUS underestimates prostate volume, independent of prostate size. We propose simple formulae that could be used to improve the prostate volume determination from TRUS, especially if magnetic resonance imaging is not readily available or contraindicated.