Brit J Hosp Med
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Aims/Background Pressure injury stands as a global healthcare concern, primarily affecting elderly individuals. As the ageing of the global population shows no signs of slowing down, both society and the families of the affected individuals continue to bear the brunt of the consequences of pressure injuries. The majority of pressure injury cases are managed at home, and the occurrence and progression of pressure injuries in the elderly are closely associated with informal caregivers. ⋯ Conclusion The findings of this study establish a collaborative relationship network among the hospitals, family, medical staff, and caregivers in the management of pressure injuries, but with a special attention to the caregivers' needs for disease-related knowledge and psychophysical support. Such relationships streamline communication between medical staff, patients, and their caregivers, facilitating the adoption of active and correct methods by caregivers to prevent and care for pressure injuries. This can positively impact the quality of care for pressure injuries, further improving the life quality of patients and their caregivers, controlling the incidence of pressure injuries, and reducing readmission rates.
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Despite record investment in Scotland's National Health Service, ever-increasing numbers of people remain in hospital despite being clinically fit for discharge. This paper curiously explores two of the whole-system problems ensuring discharges are delayed and argues that greater investment in, and contractual changes to, social care commissioning is required to support more people to live their best lives in their own homes. A more creative perspective is required to ensure better outcomes for the population.
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Patients who discharge themselves against medical advice comprise 1%-2% of hospital admissions. Discharge against medical advice (DAMA) is defined as when a hospitalised patient chooses to leave the hospital before the treating medical team recommends discharge. The act of DAMA impacts on both the patient, the staff and their ongoing care. ⋯ Patients who decide to DAMA tend to be young males, from a lower socioeconomic background and with a history of mental health or substance misuse disorder. DAMA has an associated increased risk of morbidity and mortality. In this review of studies across Western healthcare settings, specifically adult medical inpatients, we will review the evidence and seek to address the causes, consequences and possible corrective measures in this common scenario.
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Hypokalaemia is a common electrolyte disorder affecting hospitalised patients. It is associated with adverse outcomes including increased mortality. Inpatients with hypokalaemia need a different approach to workup and management as the aetiologies and progression of the hypokalaemia are distinct to outpatients. ⋯ This paper reviews the assessment of hypokalaemia in a hospital setting. It is aimed at early career doctors on the wards to help carry out a thorough evaluation. It also provides a useful framework for management.
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Review
Application of Injectable Hydrogels as Delivery Systems in Osteoarthritis and Rheumatoid Arthritis.
Osteoarthritis and rheumatoid arthritis, though etiologically distinct, are both inflammatory joint diseases that cause progressive joint injury, chronic pain, and loss of function. Therefore, long-term treatment with a focus on relieving symptoms is needed. At present, the primary treatment for arthritis is drug therapy, both oral and intravenous. ⋯ This review summarizes the types of injectable hydrogels and analyzes their applications as delivery systems in arthritis treatment. We also explored how hydrogels counteract inflammation, bone and cartilage degradation, and oxidative stress, while promoting joint cartilage regeneration in the treatment of osteoarthritis (OA) and rheumatoid arthritis (RA). This review also highlights new approaches to developing injectable hydrogels as delivery systems for OA and RA.