Articles: adult.
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Systematic review. ⋯ 3.
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Cochrane Db Syst Rev · Mar 2024
ReviewModels for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities.
The number of older people is increasing worldwide and public expenditure on residential aged care facilities (ACFs) is expected to at least double, and possibly triple, by 2050. Co-ordinated and timely care in residential ACFs that reduces unnecessary hospital transfers may improve residents' health outcomes and increase satisfaction with care among ACF residents, their families and staff. These benefits may outweigh the resources needed to sustain the changes in care delivery and potentially lead to cost savings. Our systematic review comprehensively and systematically presents the available evidence of the effectiveness, safety and cost-effectiveness of alternative models of providing health care to ACF residents. ⋯ Compared to usual care, alternative models of care may make little or no difference to the number of emergency department visits but may reduce unplanned hospital admissions. We are uncertain of the effect of alternative care models on adverse events (i.e. falls, pressure ulcers, infections) and adherence to guidelines compared to usual care, as the certainty of the evidence is very low. Alternative models of care may have little or no effect on health-related quality of life and probably have no effect on mortality of ACF residents compared to usual care. Importantly, we are uncertain of the cost-effectiveness of alternative models of care due to the limited, disparate data available.
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Huntington's disease (HD) usually manifests in adulthood and is characterised by progressive neurodegeneration in the brain that causes worsening involuntary movements, mental health and cognition over many years. Depression, anxiety and apathy are common. ⋯ Progression of HD is usually slow, and so acute deteriorations often indicate another problem, such as intercurrent infections, constipation, urinary retention, gastro-oesophageal reflux disease or poor dentition. In this review we outline common presentations in HD patients, both acute and chronic, consider therapeutic options and discuss specific considerations in advanced HD.
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Pol. Arch. Med. Wewn. · Feb 2024
ReviewPopular diets and nutritional assessment in the management of irritable bowel syndrome in inflammatory bowel disease: an overview of current evidence.
There is an increasing interest in using popular diets to manage inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn disease. These conditions are often associated with nutritional deficiencies, protein‑energy malnutrition, micronutrient malnutrition, altered body composition, and sarcopenia. While dietary interventions can be supportive in treating intestinal symptoms of adult IBD patients, it is important to note that current guidelines from major scientific societies do not recommend any specific dietary interventions in this field. ⋯ We then discuss in detail the most popular diets used for IBD management over the years, characterizing each one in terms of effects on gut inflammation, IBS‑like symptoms, and potential risk of malnutrition. These diets include a low‑fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet, a gluten‑free diet, a Mediterranean diet, and a plant‑based diet. To date, current evidence does not conclusively establish the optimal diet for patients with IBS, suggesting that personalized dietary approaches may be the best strategy.
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Review
Imaging of Adult Malignant Soft Tissue Tumors of the Spinal Canal: A Guide for Spine Surgeons.
Malignant soft tissue spinal canal tumors compromise 20% of all spinal neoplasms. They may be primary or metastatic lesions, originating from a diverse range of tissues within and surrounding the spinal canal. These masses can present as diverse emergencies such as secondary cauda equina syndrome, vascular compromise, or syringomyelia. Interpretation of malignant soft tissue spinal canal tumors imaging is an essential for non-radiologists in the setting of emergencies. This task is intricate due to a great radiologic pattern overlap among entities. ⋯ In this review, diagnostic strategies for several spinal cord tumors were presented, including anaplastic ependymoma, metastatic spinal cord tumors, anaplastic and malignant astrocytoma, lymphoma, malignant peripheral nerve sheath tumors , and primary central nervous system melanoma. Although the characterization of spinal cord tumors can be challenging, comprehensive knowledge of imaging features can help overcome these challenges and ensure optimal management of spinal canal lesions.