The 'surprise' question in advanced cancer patients: A prospective study among general practitioners.

Background: Using the 'surprise' question 'Would you be surprised if this patient died in the next year?' may improve physicians' prognostic accuracy and identify people appropriate for palliative care.

Aim: Determine the prognostic accuracy of general practitioners asking the 'surprise' question about their patients with advanced (stage IV) cancer.

Design: Prospective cohort study.

Disease management of the metabolic syndrome in a community: study design and process analysis on baseline data.

Background: A comprehensive lifestyle approach is suggested as first-line treatment for the individual features of the metabolic syndrome, but the results in community medicine are usually discouraging. No study has tested the feasibility of an integrated approach between general practitioners (GPs) and specialist centers.

Methods: We report the process analysis on baseline data of a randomized study based on the integration between GPs, selecting patients on the basis of a pre-defined grid and specific targets, and a specialist center, providing informative material and arranging courses of counseling and cognitive-behavioral therapy, using a shared database.

Are there any news about the antipsychotic medications in the elderly?

Antipsychotic drugs are widely used in people with dementia to treat neuropsychiatic symptoms such as aggression, agitation and psychosis. Using antipsychotic agents in older patients is difficult, because it depends on co-morbid conditions, side effects, dosing strategies, duration of treatments and combinations of various medications. This paper discusses the use of atypical antipsychotics in a 1-year-observation on a group of patients followed by an expert dementia center.

Outcomes from a program of home care attendance in very frail elderly subjects.

This study evaluated various outcomes of home care in a group of 121 chronically ill and frail elderly subjects followed for 24 months, starting from September 2001. The scheduled times of follow up were baseline, 6, 12, and 24 months. Subjects of both sexes were assigned to one of two groups.