Age and ageing
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Carbon monoxide poisoning represents a potentially preventable and reversible cause of mortality and morbidity if sources and cases can be identified. The elderly have been shown to be particularly at risk. Concerns continue to be raised about potential unrecognised cases of carbon monoxide poisoning. ⋯ In general carbon monoxide has no helpful unique clinical presentation and is known to mimic common illnesses as well as exacerbate established diseases. As a gas it is undetectable by the human senses and is potentially present in most households. This paper reviews the issues associated with carbon monoxide poisoning including pointers to early diagnosis and discussion of pathophysiology and management.
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Comparative Study
The epidemiology of amyotrophic lateral sclerosis (ALS/MND) in people aged 80 or over.
To describe the clinical features, incidence, survival and process of care of people with Amyotrophic Lateral Sclerosis/Motor Neurone Disease aged 80 years or more at diagnosis. ⋯ This is the first comprehensive report of the epidemiology of Amyotrophic Lateral Sclerosis/Motor Neurone Disease in older people. Clinical presentation and survival differ from the population as a whole. There is evidence of a different process of care. While this may be to the detriment of their survival, this finding would need to be confirmed by further prospective studies.
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To investigate whether a care pathway for older hip fracture patients can reduce length of stay while maintaining the quality of clinical care. ⋯ This care pathway was associated with longer hospital stay and improved clinical outcomes. Care pathways for hip fracture patients can be a useful tool for raising care standards but may require additional resources.
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Randomized Controlled Trial Clinical Trial
Prevalence and prediction of unrecognised diabetes mellitus and impaired glucose tolerance following acute stroke.
diabetes mellitus not only increases the risk of ischaemic stroke two- to four-fold but also adversely inXuences prognosis. The prevalence of recognised diabetes mellitus in acute stroke patients is between 8 and 20%, but between 6 and 42% of patients may have undiagnosed diabetes mellitus before presentation. Post-stroke hyperglycaemia is frequent and of limited diagnostic value and the oral glucose tolerance test assumes that the patient is clinically stable and eating normally. There is a need for a simple and reliable method to predict new diabetes mellitus in acute stroke patients. ⋯ one-third of all acute stroke patients may have diabetes mellitus. For patients presenting with post-stroke hyperglycaemia, impaired glucose tolerance or diabetes mellitus is present in two-thirds of survivors at 12 weeks. Admission plasma glucose > or = 6.1 mmol/l combined with glycosylated haemoglobin > or = 6.2% are good predictors of the presence of diabetes mellitus following stroke.