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Commonest Reason (commonest + reason)

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Medical Sciences100%

Selected Abstracts

Pre-operative fasting: a nationwide survey of German anaesthesia departments

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010
J.-P. BREUER
Background: Shorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. Methods: Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. Results: The overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: ,improved pre-operative comfort' (84%), and ,increased patient satisfaction' (83%); reasons against were: ,low flexibility in operation room management' (19%), and ,increased risk of aspiration' (13%). Conclusion: Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments. [source]

Management of heart failure in elderly people

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2008
M. Imazio
Summary Aims:, To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people. Methods:, To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearinghouse and a comprehensive MEDLINE search with the MeSH terms: ,heart failure', ,elderly' and ,management'. Results:, A number of features of ageing may predispose elderly people to HF, and may impair the ability to respond to injuries. Another hallmark of elderly patients is the increasing prevalence of multiple coexisting chronic conditions and geriatric syndromes that may complicate the clinical presentation and evolution of HF. Although diagnosis may be challenging, because atypical symptoms and presentations are common, and comorbid conditions may mimic or complicate the clinical picture, diagnostic criteria do not change in elderly people. Drug treatment is not significantly different from that recommended in younger patients, and largely remains empiric, because clinical trials have generally excluded elderly people and patients with comorbid conditions. Disease management programmes may have the potential to reduce morbidity and mortality for patients with HF. Conclusions:, Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups. [source]

Skin disease is common in rural Nepal: results of a point prevalence study

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008
S.L. Walker
Summary Background, Skin problems are the commonest reason for people accessing healthcare services in Nepal but there is little information about the prevalence of skin disease. Objectives, To perform a point prevalence study of skin disease in the Terai region of Nepal. Methods, Five villages were randomly selected in Bara District in the Terai region of Nepal, and 878 people were examined. Results, The number of individuals identified as having a skin disease was 546. The point prevalence of identifiable skin abnormalities was 62·2% (546 of 878) (with 95% exact confidence intervals 58·9,65·4%). A wide range of dermatoses was identified. The six most prevalent were dermatophyte infections (11·4%), followed by pityriasis versicolor (8·9%), acne (7·7%), melasma (6·8%), eczema (5·6%) and pityriasis alba (5·2%). Overall, treatable skin infections and infestations were by far the commonest skin diseases identified. Conclusions, Our study has demonstrated a very high point prevalence (62·2%) of skin disease in rural Nepal. This study represents the first formal survey of skin disease in Nepal and demonstrates a large burden of disease, in particular treatable infections. [source]

Future perspectives in the acute management of head injury,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2003
P. J. Hutchinson
Observations on one of the commonest reasons for admission to hospital [source]