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Internal Medicine Journal

Estella Yeo, Suetonia C Palmer, Peter T Chapman, Christopher Frampton, Lisa K Stamp
BACKGROUND: To estimate the point prevalence of gout, gout treatment, and achievement of target serum urate (SU) among adults treated with long-term dialysis. METHODS: Three secular cohorts of adults receiving dialysis for at least 90 days on 1st February 2017, 1st January 2016 and 1st January 2015 were identified. Medical records were reviewed for SU concentrations. Results were compared between haemodialysis (HD) and peritoneal dialysis (PD), and participants prescribed and not prescribed urate-lowering therapy...
November 13, 2018: Internal Medicine Journal
Thomas McNeil, Emily Rowe
BACKGROUND: Patients with Human Immunodeficiency Virus (HIV) infection have higher rates of cardiovascular disease, metabolic disorders and malignancy than their uninfected peers. AIM: To survey the health of a South Australian cohort of long term HIV patients, who had been diagnosed with HIV prior to the availability of combination antiretroviral therapy (cART). METHODS: Data from 88 patients was collected retrospectively across four domains: demographics, HIV history, antiretroviral medication and medical co-morbidity...
November 13, 2018: Internal Medicine Journal
Sanjay Bhandari, Pinky Jha, Krista M Lisdahl, Cecilia J Hillard, Thangam Venkatesan
BACKGROUND: Currently 29 states in the United States along with the District of Columbia have legalized cannabis in some forms. There is a paucity of data on the impact of legalization of cannabis use on hospitalizations due to cyclic vomiting syndrome (CVS). AIM: To study the trends in CVS-related hospitalizations and cannabis use in CVS in relation to legalization of recreational cannabis use in Colorado. METHODS: All hospital admissions in Colorado between 2010 -2014 with the diagnosis of CVS were identified using the Colorado State Inpatient Database (SID)...
November 13, 2018: Internal Medicine Journal
Christine Duplancic, Tania Crough, Scott C Bell
BACKGROUND: The Inter-jurisdictional National Mutual Acceptance (NMA) scheme for Human Research Ethics Committee (HREC) approvals of human research is designed to reduce the reported delays and costs of ethical review. Introduction of the NMA set forth an uncoupling of the ethics and governance review processes, permitting a single ethical review for multiple sites, whilst continuing separate governance review for each centre covering financial and operational aspects of the research project...
November 12, 2018: Internal Medicine Journal
Atul Mehta, David J Kuter, Sam S Salek, Nadia Belmatoug, Bruno Bembi, Jeremy Bright, Stephan Vom Dahl, Federica Deodato, Maja Di Rocco, Ozlem Goker-Alpan, Derralynn A Hughes, Elena A Lukina, Maciej Machaczka, Eugen Mengel, Aabha Nagral, Kimitoshi Nakamura, Aya Narita, Beatriz Oliveri, Gregory Pastores, Jordi Pérez-López, Uma Ramaswami, Ida V Schwartz, Jeff Szer, Neal J Weinreb, Ari Zimran
BACKGROUND: Gaucher disease (GD) presents with a range of signs and symptoms. Physicians can fail to recognize the early stages of GD owing to a lack of disease awareness, which can lead to significant diagnostic delays and sometimes irreversible but avoidable morbidities. AIMS: The Gaucher Earlier Diagnosis Consensus (GED-C) initiative aimed to identify signs and co-variables considered most indicative of early type 1 and type 3 GD, to help non-specialists identify 'at-risk' patients who may benefit from diagnostic testing...
November 10, 2018: Internal Medicine Journal
Roger J Smith, David A Reid, John D Santamaria
OBJECTIVE: To assess the relationship between hospital admission characteristics, including frailty, and discharge outcome after in-hospital cardiac arrest. DESIGN, SETTING, PARTICIPANTS: Prospectively collected data were retrospectively analysed for all separations from a tertiary hospital during 2008-2017 that involved rapid response team attendance for cardiac arrest. Hospital Frailty Risk Score (HFRS) and Charlson index of comorbidity were calculated from 'primary' and 'associated' ICD-10-AM diagnoses...
November 8, 2018: Internal Medicine Journal
Louise Clarke, Peter Pockney, Donna Gillies, Robert Foster, Jon Gani
BACKGROUND: The 2017 NBCSP report records a median time from positive faecal occult blood test to colonoscopy of 53 days. There is some intrinsic delay in accessing specialist medical opinion prior to colonoscopy. The aim of this study was to examine the effect of the introduction of a Direct Access Colonoscopy Service (DACS). METHODS: Using prospectively maintained databases, patients undergoing normal service (NS) colonoscopy and those referred to DACS were compared...
November 8, 2018: Internal Medicine Journal
Barry D Hock, Katie S Mulholland, Peter Ganly, Judith L McKenzie, John F Pearson, Sean A MacPherson
AIM: The impact of changes in novel agent (NA) usage on the survival of multiple myeloma (MM) patients in real world hospital settings is unclear. In New Zealand (NZ) in 2011, front-line Bortezomib became available and thalidomide availability was expanded. This retrospective study analyses the impact these change had on the survival of MM patients treated at a NZ hospital. METHODS: Clinical and overall survival (OS) data were collected on MM patients who were treated at Christchurch Hospital during 2000-2009 (pre-Cohort, n=337) and 2011-2017 (post-Cohort, n=343)...
November 8, 2018: Internal Medicine Journal
Aaron C Tan, Sarah K Jacques, Meredith Oatley, Alexander D Guminski
BACKGROUND: Patients with advanced malignancies have historically been considered poor candidates for admission to the intensive care unit (ICU), however prognosis is continually improving and requirements for ICU access is increasing. AIM: To understand the characteristics and outcomes of oncology unit patients admitted to an Australian ICU and identify potential prognostic factors. METHODS: A single-centre, retrospective, cohort study conducted at a tertiary public hospital with a quaternary ICU in Sydney, Australia...
November 8, 2018: Internal Medicine Journal
Cecily J Forsyth, Wai-Hoong Chan, Andrew P Grigg, Nathalie C Cook, Steven W Lane, Kate L Burbury, Andrew C Perkins, David M Ross
The classical myeloproliferative neoplasms (MPN) are uncommon clonal haematopoietic malignancies characterised by excessive production of mature blood cells. Clinically they are associated with thrombosis, haemorrhage, varying degrees of constitutional disturbance, and a risk of progression to myelofibrosis or acute myeloid leukaemia. Many of the disease manifestations may be ameliorated by treatment with interferon-α (IFN) but its use in Australian MPN patients has been limited due to the inconvenience of frequent injections and side effects...
November 8, 2018: Internal Medicine Journal
Poornima Varma, Anton S Rajadurai, Darcy Q Holt, David A Devonshire, Chris P Desmond, Michael P Swan, Debra Nathan, Edward T Shelton, Lani Prideaux, Catherine Sorrell, Ferry Rusli, Luke Rf Crantock, Anouk Dev, Dilip T Ratnam, Stephen Pianko, Gregory T Moore
BACKGROUND: Recent prospective studies suggest combination therapy with immunomodulators improves efficacy however long-term data is limited. We aimed to assess whether anti-TNF monotherapy was associated with earlier loss of response (LOR) than combination therapy in a real-world cohort with long-term follow-up. METHODS: A retrospective audit was conducted of Inflammatory Bowel Disease patients receiving anti-TNF therapy in a tertiary centre and specialist private practices...
October 31, 2018: Internal Medicine Journal
Jie Liu, Yan-Qiu Zhao, Xiao Han, Xiu-Feng Hu, Hong-Bo Wu, Li-Juan Chen, Yong-Ping Song
BACKGROUND: A positive correlation between serum carcinoembryonic antigen (CEA) levels and epidermal growth factor receptor (EGFR) mutations has been reported in lung adenocarcinoma patients. AIMS: To investigate retrospectively whether serum CEA levels are also associated with genotypes in a large population of advanced lung adenocarcinoma. METHODS: A large cohort of 701 patients with advanced lung adenocarcinoma was studied retrospectively...
October 31, 2018: Internal Medicine Journal
Victoria Sadick, Emma Bowcock, Stuart Lane, Ian Seppelt
BACKGROUND: Recent literature emanating from the United Kingdom and United States have reported decreasing mortality rates in patients with decompensated cirrhosis and organ failures presenting to the Intensive Care Unit (ICU). The objective of this study was to determine if there were comparable outcomes in a single centre non-transplant unit in Australia. METHODS: A retrospective observational study was conducted in a tertiary, non-liver transplant unit in Sydney, Australia...
October 31, 2018: Internal Medicine Journal
Louise Clarke, Peter Pockney, Donna Gillies, Robert Foster, Jon Gani
BACKGROUND: A Direct Access Colonoscopy Service (DACS) for the National Bowel Cancer Screening Program has become standard of care in Newcastle Public Hospitals because of the effect it has on time to colonoscopy. Cost effectiveness has not been studied to date. METHODS: Data was collected for patients referred to DACS between January 2014 and June 2016, and patients who were treated on the normal service pathway in 2013 prior to the introduction of the process...
October 31, 2018: Internal Medicine Journal
Frank S Hong, Lucy C Fox, Khai Li Chai, Kay Htun, Danielle Clucas, Susan Morgan, Merrole F Cole-Sinclair, Surender Juneja
BACKGROUND: Bone marrow biopsy (BMB) is an accepted investigation in fever of unknown origin (FUO) to uncover haematological malignancies such as lymphoma, and sometimes infections. With the advance in imaging modalities, such as 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to identify the focus of lymphoma, BMB may not contribute to the diagnosis when there are no other clinical features to suggest an underlying haematological disease. AIMS: To investigate the utility of BMB in determining the cause of FUO, when there are no other indications for BMB...
October 22, 2018: Internal Medicine Journal
John A Mackintosh, Henry M Marshall, Richard Slaughter, Taryn Reddy, Ian A Yang, Rayleen V Bowman, Kwun M Fong
BACKGROUND: We report the prevalence and progression of incidentally-detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study (QLCSS) cohort. METHODS: 256 volunteers aged 60-74, with ≥30 pack years smoking history and FEV1≥50% predicted underwent low dose Computed Tomography (CT) chest screening. Electronic search of baseline (T0) and two year follow-up (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology...
October 22, 2018: Internal Medicine Journal
Mohammed Alawami, Samadhi Wimalasena, Rajaie Ghashi, Basil Alnasrallah
BACKGROUND: Venous thromboembolism is a well-established risk in patients with primary membranous nephropathy (MN) due to deficiency in natural anti-coagulants. Recent studies suggested a higher risk of arterial thrombotic events as well in this group. We aimed to identify that risk in our cohort METHOD: We reviewed the data of all patients who had biopsy proven primary membranous nephropathy at our institute between 2003 and 2013. Clinical data were retrospectively reviewed until November 2016...
October 22, 2018: Internal Medicine Journal
Cheng Long Lu, Ruad Perera, Hussein Farrah, Justin Waring
BACKGROUND: Diabetes mellitus is an important risk factor for tuberculosis and studies in high tuberculosis burden countries have shown diabetes screening to be both feasible and to have a high yield. However, scarce information is available for low tuberculosis burden countries. Diabetes screening was previously not part of our routine practice. We aim to screen and determine the prevalence of diabetes in the Western Australian Tuberculosis Control Program. METHOD: We measured HbA1c and random plasma glucose in patients with active tuberculosis...
October 17, 2018: Internal Medicine Journal
Morgan Hepburn-Brown, Jai Darvall, Gary Hammerschlag
An acute Pulmonary Embolism (aPE) is characterised by occlusion of one or more pulmonary arteries. Physiological disturbance may be minimal, but often cardiac output decreases as the right ventricle attempts to overcome increased afterload. Additionally, ventilation-perfusion mismatches can develop in affected vascular beds, reducing systemic oxygenation. Incidence is reported at 50-75 per 100,000 in Australia and New Zealand, with 30- day mortality rates ranging from 0.5% to over 20%. Incidence is likely to increase with the aging population, increased survival of patients with co-morbidities that are considered risk factors and improving sensitivity of imaging techniques...
October 15, 2018: Internal Medicine Journal
Abbey Sawyer, Hayley Lewthwaite, Daniel F Gucciardi, Kylie Hill, Sue Jenkins, Vinicius Cavalheri
Participation in regular physical activity decreases the risk of developing cardiometabolic disease. However, the proportion of people who participate in the recommended amount of physical activity is low, with common barriers including competing interests and inclement weather. In people with chronic cardiorespiratory conditions, participation in physical activity is reduced further by disease-specific barriers; time-burden of treatment and unpleasant symptoms during physical activity. Addressing these barriers during adolescence and early adulthood may promote greater physical activity participation into older age...
October 15, 2018: Internal Medicine Journal
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