Internal medicine journal
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Internal medicine journal · Jan 2021
Community-based management of complex type 2 diabetes: adaptation of an integrated model of care in a general practice setting.
Overburdened hospital clinics can have adverse outcomes. ⋯ This study confirms the value of integrated community-based care of complex type 2 diabetes which could represent a sustainable solution to overburdened hospital diabetes outpatient clinics.
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Internal medicine journal · Jan 2021
Randomized Controlled TrialResults from a double blinded, randomised, placebo-controlled, feasibility trial of melatonin for the treatment of delirium in older medical inpatients.
Delirium is common in elderly inpatients, causing distress, cognitive decline and death. No known intervention improves the course of delirium; current treatments are symptomatic, and limited by lack of efficacy and adverse effects. There is an urgent need to find an effective treatment for delirium. ⋯ A trial of the hypothesis that 5 mg melatonin nightly for five nights reduces delirium severity in older medical inpatients would require 120 patients, and is feasible.
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Internal medicine journal · Jan 2021
Observational StudyRelationship between residual kidney function and symptom burden in haemodialysis patients.
Residual kidney function (RKF) has been associated with improved solute clearance and survival in haemodialysis (HD) patients. However, whether RKF impacts symptom burden in HD patients is unknown. ⋯ Higher RKF was significantly associated with fewer symptoms, and lower serum β2 -microglobulin and potassium, suggesting that strategies to preserve RKF may be beneficial.
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Previous studies have found an increase in mortality among patients with worsening degrees of hyponatraemia. There is limited evidence on the impact of dysnatraemia on outcomes such as length of stay (LOS) and intensive care unit (ICU) admission. ⋯ An abnormal serum sodium level is a strong marker of poor outcome in acute hospital illness.