International journal of clinical practice
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Int. J. Clin. Pract. · Jan 2020
Ambulatory emergency oncology: A key tenet of future emergency oncology care.
Ambulatory emergency oncology The challenges of emergency oncology alongside its increasing financial burden have led to an interest in developing optimal care models for meeting patients' needs. Ambulatory care is recognised as a key tenet in ensuring the safety and sustainability of acute care services. Increased access to ambulatory care has successfully reduced ED utilisation and improved clinical outcomes in high-risk non-oncological populations. ⋯ There are an increasing number of acute cancer presentations, such as low-risk febrile neutropenia and incidental pulmonary embolism, that can be risk assessed for care in an emergency ambulatory setting. Modelling of ambulatory emergency oncology services will be dependent on local service deliveries and pathways, but are key for providing high quality, personalised and sustainable emergency oncology care. These services will also be at the forefront of much needed emergency oncology to define the optimal management of ambulatory-sensitive presentations.
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Int. J. Clin. Pract. · Jan 2020
Associations between serum potassium and adverse clinical outcomes: A systematic literature review.
Despite the growing body of evidence characterising the association between serum potassium levels and adverse clinical outcomes, a contemporary summary of available evidence is currently lacking. The objective of this study, therefore, was to undertake a systematic literature review to identify all relevant evidence assessing risk factors associated with the incidence of hyperkalaemia (HK) and also quantifying the effect of serum potassium levels on risk of adverse clinical outcomes. ⋯ The current body of published evidence is compelling in its confirmation of the associations between serum potassium levels and adverse clinical outcomes. This review further highlights the importance of avoiding both hyper- and hypokalaemia, in order to reduce risk of mortality, hospitalisation, MACE and RAASi discontinuation or down-titration.
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Osteoarthritis is a common debilitating condition affecting a substantial portion of the population and is an accepted consequence of ageing and overuse. Whilst surgical interventions are a definitive approach, most cases are managed medically with analgesia. ⋯ Although significant controversies exist in the use of opioids for chronic musculoskeletal pain, many leading guidelines continue to recommend its use despite increasing evidence to suggest an increase in addiction, morbidity and mortality. With the opiate crisis growing, we re-examine the role opiates have in this chronic condition and current data, and briefly evaluate alternative therapies.
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Int. J. Clin. Pract. · Jan 2020
Clinical implication of chronic paranasal sinusitis for the classification of microscopic polyangiitis.
Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). ⋯ CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.
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Although healthy volunteers often serve as controls or primary participants in neuroscience research, they are usually less rigorously screened than patients, which can have far-reaching implications for interpretation of study results. Although this issue has long been recognised, it is rarely discussed in the research literature. This article examines how the rigorous screening and characterisation of healthy volunteers is key for quality research.