International journal of clinical practice
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Int. J. Clin. Pract. · Apr 2009
Multicenter Study Clinical TrialSafety and effectiveness of biphasic insulin aspart 30/70 (NovoMix 30) when switching from human premix insulin in patients with type 2 diabetes: subgroup analysis from the 6-month IMPROVE observational study.
IMPROVE is an open-label, multinational, non-randomised, 26-week observational study designed to evaluate the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in routine clinical practice. Here, we report data for patients switching to BIAsp 30 from human premixed insulin. ⋯ A unit-for-unit switch is the most effective as well as the simplest approach when transferring patients from biphasic human insulin 30 to BIAsp 30.
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Int. J. Clin. Pract. · Apr 2009
In-hospital mortality and morbidity of elderly medical patients can be predicted at admission by the Modified Early Warning Score: a prospective study.
Although early warning scores were originally derived as bedside tools for alerting the medical staff, they may serve as decision rules for the admission of medical patients. We conducted this study to investigate the ability of the Modified Early Warning Score (MEWS) to identify a subset of patients at risk of deterioration, who might benefit from an increased level of attention. ⋯ We have confirmed that the MEWS, even when calculated once on admission, is a simple but highly useful tool to predict a worse in-hospital outcome.
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Int. J. Clin. Pract. · Apr 2009
Incidence of neuropsychiatric adverse events in influenza patients treated with oseltamivir or no antiviral treatment.
The association between neuropsychiatric events and antiviral treatments for influenza has been under scrutiny. In this study, the incidence of neuropsychiatric events in influenza patients dispensed oseltamivir or no antiviral was assessed using a large US medical claims database. ⋯ In this retrospective cohort study, no increase in claims-based neuropsychiatric events was detected in influenza patients who were and were not exposed to oseltamivir.
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Int. J. Clin. Pract. · Mar 2009
ReviewDying in an acute hospital setting: the challenges and solutions.
More than half of all UK deaths occur in hospital, yet evidence suggests that the quality of inpatient end of life care is suboptimal at best. Over half of all NHS complaints pertain to problems with care in the dying phase, particularly with regard to poor communication. This is a hugely topical area following the recent publication of the Department of Health's End of Life Care Strategy. With reference to current literature, we seek to investigate the challenges associated with providing 'a good death' in hospital and construct a framework of strategies for improvement; including communication skills training, use of integrated care pathways, advance planning, educational initiatives and the role of the palliative care team.
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Int. J. Clin. Pract. · Mar 2009
Review Comparative StudyCost-effectiveness analysis of linezolid vs. vancomycin in treating methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections using a decision analytic model.
To evaluate the cost-effectiveness of vancomycin vs. linezolid in complicated skin and soft tissue infections (cSSTIs) with methicillin-resistant Staphylococcus aureus (MRSA) using a decision analytic (DA) model. ⋯ Alternative vancomycin strategies (VAN-2 and VAN-3) that take advantage of early discharge opportunities were cost-effective compared with LIN. However, LIN's higher efficacy would make it cost-effective for payers with a high WTP threshold.