International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2013
ReviewUltrasound-guided subclavian venous catheterisation - is this the way forward? A narrative review.
Central venous catheterisation is a commonly performed procedure in anaesthesia, critical care, acute and emergency medicine. Traditionally, subclavian venous catheterisation has been performed using the landmark technique and because of the complications associated with this technique, it is not commonly performed in the United Kingdom - where the accepted practice is ultrasound-guided internal jugular vein catheterisation. ⋯ Barriers to this approach include many physicians still believing that the clavicle obscures imaging of the vein. In this article, we review the evidence supporting ultrasound-guided subclavian vein catheterisation and ask the question whether, in view of it potential advantages, it could be the way forward?
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Int. J. Clin. Pract. · Aug 2013
Meta AnalysisClinically relevant reductions in HbA1c without hypoglycaemia: results across four studies of saxagliptin.
In four 24-week controlled studies, the antihyperglycaemic efficacy of saxagliptin was demonstrated in patients with type 2 diabetes mellitus as add-on therapy to glyburide, a thiazolidinedione, or metformin, and when used in initial combination with metformin vs. metformin monotherapy in drug-naive patients. ⋯ Whether receiving saxagliptin as an add-on therapy to glyburide, a thiazolidinedione, or metformin or in initial combination with metformin, a greater percentage of patients achieve clinically relevant large reductions in HbA(1c) vs. comparator, with a low incidence of hypoglycaemia.
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Int. J. Clin. Pract. · Aug 2013
Pragmatic Clinical TrialFront-loading allied health intervention in the emergency department does not reduce length of stay for admitted older patients.
Allied health intervention may play an important role in the timely discharge of older people admitted to hospital. The impact of early allied health intervention on length of stay has not been quantified. We sought to determine whether early allied health intervention conducted in the emergency department (ED) reduces hospital length of stay in older patients admitted with common diagnoses. ⋯ Front loading allied health assessment in ED has no effect on hospital length of stay.
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Accurate, complete and timely publication of research studies is an integral part of a responsible research conduct. Following the reporting guidelines helps in preparing high quality research papers, facilitates peer review, and increases the chances of paper acceptance by a suitable journal. The EQUATOR Network website (www.equator-network.org) provides a collection of reporting guidelines and other resources helping researchers to publish their research studies.
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Int. J. Clin. Pract. · Aug 2013
Comparative StudyLower incidence of inappropriate shock therapy in patients with combined cardiac resynchronisation therapy defibrillators (CRT-D) compared with patients with non-CRT defibrillators (ICDs).
A significant number of patients experience inappropriate shock therapy (IST) from implantable cardioverter-defibrillators (ICD). An increasing number of patients with advanced heart failure receive combined ICD and cardiac resynchronisation therapy devices (CRT-D). The incidence of IST in this group is less well described. We aimed to assess the incidence and predictors of IST in CRT-D patients. ⋯ Patients with CRT-D had a significantly lower incidence of IST compared with patients receiving an ICD. Given that atrial arrhythmia remained the commonest trigger for IST, our finding lends support to the hypothesis that CRT may reduce atrial fibrillation burden in patients receiving CRT-D.