Clinical medicine (London, England)
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Frequent emergency readmissions may associate with health consequences. We examined the association between readmissions within 28 days of hospital discharge and mortality in 32,270 alive-discharge episodes (18-107 years). ⋯ Eight conditions associated with AR episodes had increased risk of mortality including congestive heart failure: HR = 2.7 (2.2-3.2), chronic pulmonary obstructive disease: HR = 3.0 (2.5-3.6), pneumonia: HR = 2.0 (1.8-2.3), sepsis: HR = 2.2 (1.9-2.5), endocrine disorders: HR = 1.9 (1.6-2.3), urinary tract infection: HR = 1.5 (1.3-1.7), psychiatric disorders: HR = 1.5 (1.1-2.1) and haematological disorders: HR = 1.5 (1.2-1.9). Frequent identical AR episodes, particularly from chronic and age-related conditions, are associated with increased mortality.
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Diabetes mellitus is a common condition which all clinicians will encounter in their clinical practice. The most common form is type 2 diabetes followed by type 1 diabetes. ⋯ This article focuses on maturity onset diabetes of the young (MODY), latent autoimmune diabetes in adults (LADA), ketosis-prone diabetes and other secondary forms of diabetes such as pancreatic cancer and haemochromatosis. We briefly describe the key clinical features of these forms of diabetes and their investigations and treatment.
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Eating and drinking are essential for maintenance of nutrition and hydration, but are also important for pleasure and social interactions. The ability to eat and drink hinges on a complex and coordinated system, resulting in significant potential for things to go wrong. The Royal College of Physicians (RCP) has published updated guidance on how to support people who have eating and drinking difficulties, particularly towards the end of life. ⋯ The newly updated guidance aims to support healthcare professionals to work together with patients, their families and carers to make decisions around nutrition and hydration that are in the best interests of the patient. It covers the factors affecting our ability to eat and drink, strategies to support oral nutrition and hydration, techniques of clinically-assisted nutrition and hydration, and the legal and ethical framework to guide decisions about giving and withholding treatment, emphasising the two key concepts of capacity and best interests. This article aims to provide an executive summary of the guidance.
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Obesity is a modifiable risk factor in the development of type 2 diabetes mellitus (T2DM), with the prevalence of both increasing worldwide. This trend is associated with increasing mortality, cardiovascular risk and healthcare costs. An individual's weight will be determined by complex physiological, psychological and societal factors. ⋯ Common diabetes medications may lead to weight gain whereas others (such as glucagon-like peptide-1 agonists and sodium-glucose cotransporter-2 inhibitors) support weight loss. Bariatric surgery improves obesity-related complications and all-cause mortality. Diabetes remission is possible after surgery and is recommended by National Institute for Health and Care Excellence in individuals with a body mass index of >35 kg/m2 and recent onset T2DM.
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A target sign has not been described in other viral or bacterial pneumonia on computed tomography of the chest in literature. It could represent a hallmark of COVID-19 pneumonia, given the good correlating clinical context and prevalence of COVID-19.