Reducing hospital bed use by frail older people: results from a systematic review of the literature.

Introduction: Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay (LOS) amongst frail older people. In this study, we have undertaken a systematic review of the recent international literature (2007-present) to help improve our understanding about the impact of these interventions.

Methods: WE SYSTEMATICALLY SEARCHED THE FOLLOWING DATABASES: PubMed/Medline, PsycINFO, CINAHL, BioMed Central and Kings Fund library.

Allergic bronchopulmonary aspergillosis causing total lung collapse.

Allergic bronchopulmonary aspergillosis (ABPA) is commonly associated with underlying respiratory disease. The authors present the case of a 68-year-old non-smoker, admitted with a possible acute coronary syndrome, who deteriorated in hospital secondary to total left lung collapse as demonstrated on chest radiograph. There was no significant history of respiratory disease.

An aromatic mystery.

A case of antiepileptic hypersensitivity syndrome presenting as an acute septic illness is reported. A 67-year-old man, with a history of essential hypertension (treated with amlodipine) and recently diagnosed nocturnal epilepsy (treated with phenytoin), presented initially with an acute pneumonic illness with periorbital oedema. This was treated successfully with antibiotics and his phenytoin was changed to carbamazepine due to concerns regarding the periorbital oedema.

Stage IV carcinoma of the Bartholin gland managed with primary chemoradiation.

Background: Optimal management of carcinoma of the Bartholin gland is not yet defined. Patients with locally advanced disease have historically been managed by radical and, occasionally, exenterative surgery. Although the management of advanced vulvar cancer has shifted toward conservative management with primary chemoradiation, there is limited information on the similar approach to the management of advanced Bartholin's gland carcinoma.