Is the fast-track process efficient and safe for older adults admitted to the emergency department?

BACKGROUND: The efficiency of the fast-track (FT) process in the management of patients in Emergency Departments is well demonstrated, but there is a lack of research focused on older adults. The aim of our study was to verify whether the FT process is efficient and safe for older adults admitted to ED. METHODS: Observational case-control single-centre study. RESULTS: Five hundred four cases and 504 controls were analysed. The mean age was 75 years, and there was a predominance of women. In total 96% of subjects were classified with a "less-urgent" tag. The length of stay was significantly lower in the fast-track group than in the control group (median 178 min, interquartile range 184 min, and 115 min, interquartile range 69 min, respectively, p < 0.001), as well as the time spent between the ED physician's visit and patient discharge (median 78 min, interquartile range 120 min, and median 3 min, interquartile range 6 min, respectively, p < 0.001). There weren't any increases in the number of unplanned readmissions within 48 h, 7 days and 30 days. CONCLUSIONS: The fast-track appears to be an efficient and safe strategy to improve the management of older adults admitted to the ED with minor complaints.

Transforming activity of DNA extracted from human urological tumours.

The transforming activity of DNA extracted from one testicular cancer, one benign prostatic hyperplasia, two malignant prostatic adenocarcinomas, six renal cell carcinomas, two tumours of the renal pelvis, a specimen of normal urothelial tissue, two benign papillomas of the bladder and five malignant bladder carcinomas, was investigated using a DNA transfection assay on primary cultures of hamster kidney cells (HK cells) and mouse embryo fibroblasts (MEF cells). Transformation was scored under light microscope by the appearance of foci of morphologically transformed cells and by evaluating the ability of the transfected cells to from colonies in soft agar. Primary HK cells were unable to support transformation by human tumour DNA because of their very limited lifespan in vitro; MEF cultures, on the contrary, had a much more prolonged life: but were only abortively transformed by DNA from four out of six renal cell carcinomas and four out of seven malignant urothelial tumours, suggesting that transforming genes are present but not activated in the DNA from these urological malignancies.