Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2007
Review[Medical treatment of chemotherapy-induced nausea and vomiting].
Patients consider nausea and vomiting among the worst side effects of chemotherapy. This paper reviews the development of antiemetics during the past 12 years, focusing on the neurokinin (NK)1-receptor antagonist, aprepitant, and the new 5-HT3-receptor antagonist palonosetron. ⋯ Antiemetics are effective in prevention of vomiting, but less effective against nausea. Therefore studies with potential new antiemetics, such as olanzapine and ghrelin are awaited with suspense.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Fast-tracking admission from emergency room to orthopaedic ward in hip fracture patients].
The traditional admission protocol for hip fracture patients often results in long waiting hours in the A&E. The aim of this study was to investigate the effect of an optimised admission protocol on the time spent in the A&E in an already established multimodal rehabilitation program. ⋯ An optimised admission protocol, including nurse requested X-ray for hip fracture patients, led to a reduction in the time spent in the A&E.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Diagnosis Related Groups in intensive care units--cost model for critically ill patients].
The actual contribution of intensive care to total hospital costs in Denmark has yet not been completely identified. In order to adapt the DRG system to better reflect the actual costs of the intensive care units (ICUs) the original primarily diagnosis-based DRG system was modified in order to be based on ICU-related procedure codes. A new DRG system for ICU patients was developed and implemented in 2004. ⋯ As a result there has since been a qualitative improvement in the documentation of the activities in the ICUs. The information categorized according to the new ICU DRG-groups allows for better differentiation of patients, and might lead to an increasing understanding of the quality of healthcare provision in the ICU by the use of comparisons in a database. A meaningful cost comparison between intensive care units can only be made by combining activity with quality of delivered care.
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It is now documented that intensive care units do consider whether treatments promote "the good" and serve patients best. Uncritical use of technology to prolong the dying process must be avoided, and palliative principles worked out. ⋯ However, there are major differences as to how the law is acted upon. Guidelines for futile intensive care treatment should therefore be worked out, and uncritical referral of patients to the ICU avoided.