International journal of clinical practice
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Int. J. Clin. Pract. · Oct 2018
In-hospital outcomes for solid organ transplants according to type 2 diabetes status: An observational, 15-year study in Spain.
To describe trends and outcomes during admission for solid organ transplant in people with or without type 2 diabetes in Spain, 2001-2015. ⋯ Admission rates for solid organ transplant were higher in people with type 2 diabetes than in people without diabetes. Type 2 diabetes was associated with lower in-hospital mortality during admission for heart and liver transplant.
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Int. J. Clin. Pract. · Oct 2018
Inpatient disposition in overcrowded hospitals: is it safe and effective to use reverse triage and readmission screening tools for appropriate discharge? An observational prospective study of an Italian II level hospital.
Reverse triage (RT) identifies patients eligible for discharge and have been proposed to cope with daily surge. Nevertheless, early discharge could increase the rate of readmission. Our aim is to test the effectiveness and safety of RT alone and with readmission screening tools (Identification Senior At Risk [ISAR], HOSPITAL, and Groeningen Frailty Index [GFI] scores) to predict appropriate discharge. ⋯ Reverse triage proved to be a safe and conservative tool, with high specificity alone and with readmission screening tools. RT correctly identifies patients that will be discharged earlier.
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Int. J. Clin. Pract. · Oct 2018
Review Meta AnalysisAntibiotic de-escalation in patients with pneumonia in the intensive care unit: A systematic review and meta-analysis.
Antibiotic de-escalation is part of an antibiotic stewardship strategy to achieve adequate therapy for infections while avoiding the prolonged use of broad-spectrum antibiotics. However, there is a paucity of clinical evidence on the clinical impact of this strategy in pneumonia patients in the intensive care unit (ICU). This review aimed to evaluate the impact of antibiotic de-escalation therapy for adult patients diagnosed with pneumonia in the ICU. ⋯ This review highlights the need for more rigorous studies to be carried out before a firm conclusion on the benefit of de-escalation therapy is supported.
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Int. J. Clin. Pract. · Oct 2018
ReviewRisk of hypoglycaemia in people aged ≥65 years receiving linagliptin: pooled data from 1489 individuals with type 2 diabetes mellitus.
To investigate the risk of hypoglycaemia in people aged ≥65 years with type 2 diabetes mellitus (T2DM) treated with linagliptin, in the largest pooled analysis performed to date. ⋯ This pooled analysis indicates that linagliptin was effective in treating older people with T2DM towards their HbA1c targets with a favourable safety and tolerability profile and low risk of hypoglycaemia. The safety profile was maintained even on background therapies with known risk of hypoglycaemia, such as insulin and SU.