International journal of clinical practice
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Post-stroke neglect is common and an independent predictor of functional outcome. Assessment of neglect is very demanding, the treatment extremely difficult and the literature vast; we performed a literature search for all aspects of this difficult subject. ⋯ The most important historical papers were selected along with the most widely accepted and proven strategies for assessment and treatment. Standardised assessment of neglect does not always occur, but several useful strategies are available and are described in the following sections.
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Int. J. Clin. Pract. · Apr 2013
Barriers to involving older people in their resuscitation decisions: the primary-secondary care mismatch highlights the potential role of general practitioners.
'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) orders are made frequently for older people in hospital. Sensitive anticipatory discussion is encouraged where possible, but usually this does not happen, despite the evidence suggesting that many older patients would like to be involved in such decisions. ⋯ Further support and training could help clinicians improve their resuscitation decision-making practice. Advanced discussion in Primary Care with older people before they lose capacity may have a role in increasing their involvement in resuscitation decision making.
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Int. J. Clin. Pract. · Apr 2013
Randomized Controlled Trial Multicenter Study Comparative StudySaxagliptin vs. glipizide as add-on therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin alone: long-term (52-week) extension of a 52-week randomised controlled trial.
To compare the long-term safety, tolerability and efficacy of saxagliptin vs. glipizide as add-on therapy to metformin. ⋯ A lower risk of hypoglycaemia and reduced body weight were observed with saxagliptin vs. glipizide. No other clinically significant differences were observed between groups in safety profile. No significant between-group differences were observed for reductions in glycaemic parameters. After week 24, a smaller weekly rise in HbA1c was observed with saxagliptin vs. glipizide as add-on therapy to metformin.
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Int. J. Clin. Pract. · Mar 2013
Randomized Controlled Trial Comparative StudyAgomelatine and sertraline for the treatment of depression in type 2 diabetes mellitus.
The present study compared the efficacy of agomelatine and sertraline in the treatment of symptoms of depression/anxiety, diabetes self-care and metabolic control in a sample of depressed patients with non-optimally controlled type 2 diabetes mellitus (DM). ⋯ The main finding of the present small pilot study was that agomelatine may be a promising agent in the treatment of symptoms of depression and anxiety as well as in the improvement of health-related behaviours, in depressed patients with type 2 DM possibly offering some advantages over sertraline. However, the lack of a placebo control group limits the generalisability of the findings and warrants further studies.
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Special attention has been given to the effect of vitamin D supplementation on fertility outcomes in both sexes. ⋯ Recent data on vitamin D provide new insights in the complex pathogenesis and treatment of infertility.