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Non-invasive ventilation (NIV) has become the standard of care for most patients with ventilatory failure due to an acute exacerbation of chronic obstructive pulmonary disease (COPD). In all but a small minority, even of the very sickest, there is little to be lost by at least a short trial of NIV. ⋯ There are no randomised controlled trials of NIV in patients with acute ventilatory failure due to obesity but the outcome from invasive ventilation is poor and the results of NIV encouraging. Finally, NIV may have a role during the transition from active care, aimed to extend life, to palliative care.
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Patients discharged from acute care hospitals may be at risk for unintentional discontinuation of medications prescribed for chronic diseases. The intensive care unit (ICU) may pose an even greater risk because of the focus on acute events and the presence of multiple transitions in care. ⋯ Patients prescribed medications for chronic diseases were at risk for potentially unintentional discontinuation after hospital admission. Admission to the ICU was generally associated with an even higher risk of medication discontinuation.
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For many years, epidemiological studies continued to suggest that high fat diets are linked to an increased incidence of certain cancers. However, whether the oncogenic properties of fat are associated with their quantity rather than the quality has become debatable. ⋯ A firm conclusion cannot be drawn yet because of insufficient research. This paper reviews the current knowledge of the effects of saturated fats, different types of unsaturated fats, and fat-soluble vitamins on the etiology of cancer.
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African health sciences · Dec 2012
Mammographic breast density patterns among a group of women in sub Saharan Africa.
Mammographic breast density is a measure of parenchymal breast patterns on film and in part a marker of cumulative exposure to oestrogen. The risk of breast cancer for women with increased density is up to six fold more than in women with less dense tissues. The pattern of mammographic breast density among Ugandan women is not known. ⋯ Mammographic densities in this Ugandan population appear to be of low grade. The pattern established here is markedly different from findings in other studies that indicated much higher proportions for high dense tissues in other races. Mammographic interpretation of films could therefore be easier.
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The psoas muscle has been shown to predict patient outcomes based on the quantification of muscle area using computed tomography (CT) scans. The accuracy of morphomic analysis on other muscles has not been clearly delineated. In this study, we determine the correlation between temporalis muscle mass, psoas muscle area, age, body mass index (BMI), and gender. ⋯ We demonstrate that dimensions of the temporalis muscle can be quantified and may serve as a proxy for age. Going forward, we aim to assess the utility of temporalis and psoas morphomics in predicting complication rates among trauma patients admitted to the hospital to predict outcomes in the future.