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Internal Medicine Journal

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https://www.readbyqxmd.com/read/27860194/description-and-student-self-evaluation-of-a-pilot-small-group-learning-and-integrated-simulation-program-for-medical-students-in-the-first-clinical-year
#1
M R Levinson, D Kelly, K Zahariou, M Johnson, C Jackman, Sara Mackenzie
INTRODUCTION: Contemporary education for medical students should be student centered, integrated and contextualized. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem based learning and simulation program (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualize theory into work relevant practice...
November 17, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860254/physician-performed-chest-ultrasound-progress-and-future-directions
#2
E J Denton, L M Hannan, M Hew
BACKGROUND: Pleural ultrasound guidance reduces complications of pleural procedures, and lung ultrasound can diagnose the cause of acute respiratory failure. Yet as recently as five years ago, many respiratory physicians lacked sufficient access, training and expertise to perform chest ultrasound. AIMS: This study examines whether progress has been achieved in chest ultrasound amongst respiratory physicians in Australia and New Zealand. METHODS: We conducted a web-based chest ultrasound survey of adult respiratory physicians across Australia and New Zealand...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860148/a-review-of-rapid-access-cardiology-services-can-these-reduce-the-burden-of-acute-chest-pain-on-australian-and-new-zealand-health-services
#3
REVIEW
Harry Klimis, Aravinda Thiagalingam, Mikhail Altman, Emily Atkins, Gemma Figtree, Harry Lowe, N Wah Cheung, Pramesh Kovoor, A Robert Denniss, Clara K Chow
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860144/the-not-so-innocent-heart-murmur-a-five-year-experience
#4
Shaw-Hua Kueh, Thomas Pasley, Miriam Wheeler, James Pemberton
BACKGROUND: Auckland City Hospital (ACH) established a Heart Murmur Clinic (HMC) with the aim of providing prompt assessment of patients with asymptomatic systolic murmurs. This may lead to early intervention and improved outcomes if significant structural heart disease is detected and reassurance if no significant findings found. Similar clinics for children have proven beneficial; the benefit of a HMC in an adult population has been difficult to determine. OBJECTIVES: To review the clinical demographics and echocardiographic information of patients presenting to our HMC and to assess what proportion had significant structural heart disease and determine the common structural abnormalities in this population...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860102/high-prevalence-of-sessile-serrated-adenomas-in-contemporary-outpatient-colonoscopy-practice
#5
Mark Bettington, Neal Walker, Tony Rahman, Ann Vandeleur, Vicki Whitehall, Barbara Leggett, John Croese
BACKGROUND: Sessile serrated adenomas are the polyp precursor of 15-20% of colorectal carcinomas. There is debate about their prevalence and increasing discussion about the need for a serrated polyp detection rate as a quality indicator for colonoscopy. AIMS: We aimed to assess the prevalence of sessile serrated adenomas at an outpatient gastroenterology service. METHODS: This is a retrospective study of an unselected consecutive series of patients who had an outpatient colonoscopy between April 2013 and May 2014...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860085/clinical-profile-and-treatment-outcomes-of-advanced-neuroendocrine-tumours-in-rural-and-regional-patients-a-retrospective-study-from-a-regional-cancer-center-in-north-queensland-australia
#6
Umbreen Hafeez, Abhishek Joshi, Manoj Bhatt, Jenny Kelly, Sabe Sabesan, Venkat Vangaveti
AIM: To study the clinical profile, treatment and survival outcomes for advanced neuroendocrine tumour (NET) patients in Australian regional and remote settings. METHODS: We reviewed all adult patients who were diagnosed with NETs between 1994 and 2012. Patients' data was extracted from electronic databases of The Townsville Cancer Centre. Remoteness was based on postcodes with patients stratified as regional or rural North Queensland according to Australian Standard Geographical Classification (ASGC)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860078/pulmonologist-performed-transoesophageal-sampling-for-lung-cancer-staging-using-an-endobronchial-ultrasound-videobronchoscope-an-australian-experience
#7
Hari Wimaleswaran, Michael W Farmer, Louis B Irving, Barton R Jennings, Daniel P Steinfort
BACKGROUND: Transoesophageal endobronchial ultrasound (EBUS) video-bronchoscope insertion provides pulmonologists access to conduct endoscopic fine-needle aspiration (EUS-B-FNA) of mediastinal lymph node (LN) lesions and also assist in lung cancer staging by sampling left adrenal gland (LAG) lesions. Limited literature have described additional diagnostic value, whilst maintaining patient safety. METHODS: All eligible patients with paraoesophageal lesions on thoracic computed tomography (CT) underwent pulmonologist-performed EUS-B-FNA at two tertiary centres and were included in this prospective observational cohort study...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27862809/assessing-understanding-patients-prescribed-natalizumab-for-multiple-sclerosis-individual-risk-and-symptoms-of-progressive-multifocal-leukoencephalopathy
#8
Louise Rath, Nirosen Vijiaratnam, Olga Skibina
BACKGROUND: Natalizumab, a monoclonal antibody directed against α4 integrin, is a highly efficacious treatment commonly used in Relapsing Remitting Multiple Sclerosis (MS). Natalizumab is associated with the potentially fatal rare demyelinating opportunistic brain infection, progressive multifocal leukoencephalopathy (PML). Prognosis and disability from PML is determined by early diagnosis. Written tools are mandated in Australia and other prescribing countries with the aim to help patients understand the risks associated with treatment and ensure familiarity with the early symptoms of PML...
November 9, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27862783/an-audit-of-coagulation-screening-in-patients-presenting-to-the-emergency-department-for-potential-stroke-thrombolysis
#9
Katie Thorne, Harry McNaughton, Mark Weatherall
AIM: To assess time to coagulation screening results in patients presenting for potential stroke thrombolysis. METHODS: Retrospective cohort study of patients assessed for thrombolysis for stroke at Wellington Hospital between January and June 2014. We assessed time from presentation to receipt of laboratory specimen, processing time and total time from presentation to result availability; and whether times differed by receipt time. RESULTS: During the audit period, 97 unique patients, and 99 clinical episodes, were assessed for stroke thrombolysis...
November 9, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27860070/cha2-ds2-vasc-score-predicts-unsuccessful-electrical-cardioversion-in-patients-with-persistent-atrial-fibrillation
#10
Elzbieta Mlodawska, Anna Tomaszuk-Kazberuk, Paulina Lopatowska, Marcin Kaminski, Wlodzimierz Jerzy Musial
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia occurring in 2% of the population. It is known that AF increases morbidity and limited quality of life. The CHA2 DS2 VASc score is widely used to assess thrombotic complications. The CHA2 DS2 VAS score was not used till now in predicting effectiveness of electrical cardioversion. AIM: The aim of the study was to assess the value of CHA2 DS2 VASc score in predicting unsuccessful electrical cardioversion...
November 9, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27800661/incidence-time-of-occurrence-and-response-to-heart-failure-therapy-in-patients-with-anthracycline-cardiotoxicity
#11
Arshad A Khan, Asma Ashraf, Rajinder Singh, Adil Rahim, Walid Rostom, Mumtaz Hussain, Ian Renner, Nicholas J Collins
BACKGROUND: Anthracyclines are commonly used chemotherapeutic medications. In the current analysis we evaluated all-cause mortality and incidence, timing and response to medical therapy of anthracycline cardiotoxicity. METHODS: Left ventricular ejection fraction (LVEF) was serially assessed using gated heart pool scan/echocardiography in patients receiving anthracycline based chemotherapy from January 2009 to December 2014. RESULTS: A total of 1204 patients were administered anthracyclines during the study period...
November 1, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27800653/problem-based-learning-in-internal-medicine-virtual-patients-or-paper-based-problems-%C3%A5
#12
Monika Sobocan, Neja Turk, Dejan Dinevski, Radovan Hojs, Breda Pecovnik Balon
BACKGROUND: Teaching using paper problem-based learning (p-PBL) sessions has left some students fatigued with the learning process. Therefore, attempts have been made to replace p-PBL with digitally enhanced, decision-making PBL in the form of virtual patients (VPs). Student enthusiasm for substituting p-PBL with VPs has not been quantitatively evaluated on the intended educational effects. AIM: To determine the educational effects of substituting p-PBL sessions with VPs on undergraduate medical students in their internal medicine course...
November 1, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27800646/examining-the-impact-of-regular-aspirin-use-and-pik3ca-mutations-on-survival-in-stage-2-colon-cancer
#13
Caitlin Murphy, Natalie Turner, Hui-Li Wong, Mathu Sinnathamby, Jeanne Tie, Belinda Lee, Jayesh Desai, Iain Skinner, Michael Christie, Ryan Hutchinson, Sebastian Lunke, Paul Waring, Peter Gibbs, Ben Tran
BACKGROUND: Data suggest aspirin improves survival in CRC harbouring PIK3CA mutations. The impact of aspirin is thought predominantly to be via an anti-inflammatory effect. AIMS: To explore the effect of aspirin use on survival in a real world cohort of Stage 2 colon cancer (CC) patients. METHODS: A prospective CRC database identified patients diagnosed with stage 2 CC between 2000 and 2011. PIK3CA mutation status was determined by next generation sequencing...
November 1, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27761992/obesity-and-hypertension-in-australian-young-people-results-from-the-australian-health-survey-2011-to-2012
#14
Siah Kim, Joshua R Lewis, Louise A Baur, Petra Macaskill, Jonathan C Craig
BACKGROUND: Few studies have focused on the prevalence of obesity and hypertension among young people (ages 15 to 24).. AIM: To characterise the prevalence of obesity and systolic hypertension in young people aged 15 to 24 years across Australia.. METHODS: Using data from the 2011-2012 Australian Health Survey, a national cross-sectional population-based survey, we included 2 163 young people aged 15 to 24 years. Risk factors were estimated using multinomial logistic regression...
October 20, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27753283/is-parenteral-chemotherapy-safe-in-rural-hospitals-a-prospective-audit-of-febrile-neutropenia-in-albany-hospital-a-regional-west-australian-cancer-centre
#15
Kim Robyn Kennedy, Assoc Prof Kirsten Auret
BACKGROUND: Febrile neutropenia is a life-threatening complication of chemotherapy. The widely dispersed population of Australia creates challenges for rural patients in accessing healthcare services. Cancer treatment is particularly burdensome with patients being forced to relocate to the city for treatment, or to endure long and repeated journeys to the city. This study aimed to assess the safety of chemotherapy in a rural centre with a General Physician-led model, by analysing febrile neutropenia in Albany Hospital, a regional cancer centre in Western Australia...
October 18, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27753208/formalising-multidisciplinary-peer-review-developing-a-haematological-malignancy-specific-electronic-proforma-and-standard-operating-procedure-to-facilitate-procedural-efficiency-and-evidence-based-clinical-practice
#16
J Trotman, J Trinh, Y L Kwan, J A Estell, J Fletcher, K Archer, K Lee, K Foo, J Curnow, A Bianchi, L Wignall, E Verner, R Gasiorowski, E Siedlecka, I Cunningham
BACKGROUND: Multidisciplinary Team (MDT) meetings aimed at facilitating peer review have become standard practice in oncology. However, there is scant literature on the optimal structure and conduct of such meetings. AIMS: We aimed to develop a process for formal peer review of patients with haematologic malignancies, and to audit any resulting changes made to the management recommendations of the treating physician. METHODS: A standard operating procedure (SOP) for MDT meetings was developed essentially to integrate clinical peer review with weekly pathology and radiology meetings...
October 18, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27753184/spinal-infections-in-older-people-an-analysis-of-demographics-presenting-features-microbiology-and-outcomes
#17
Sanka Amadoru, Kwang Lim, Mark Tacey, Craig Aboltins
AIMS: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. METHODS: Clinical, microbiological and radiological information was collected for patients at a single metropolitan hospital with spinal infections (spondylodiscitis, vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscess) between January 2008 and January 2015. Patients were excluded if under 18 years of age, or if clinical and imaging findings were inconsistent with the diagnosis...
October 18, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27749012/injury-trends-from-envenoming-in-australia-2000-2013
#18
Ronelle E Welton, David J Williams, Danny Liew
BACKGROUND: This study provides the first contemporary epidemiological insight into venomous injuries based on demographics and geography in Australia in the timeframe 2000-2013. METHODS: Analysis of national hospitalisation and mortality data to examine the incidence of injury and death due to envenoming in Australia. Rates were calculated using the intercensal population for all Australian age groups. RESULTS: Over the study period, deaths were due to an anaphylactic event (0...
October 17, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27749003/use-of-palliative-chemotherapy-in-patients-aged-80-years-and-over-with-incurable-cancer-experience-at-3-sydney-cancer-centres
#19
Emilia Ip, Adrian M J Pokorny, Stephen Della-Fiorentina, Philip Beale, Victoria Bray, Belinda E Kiely, Prunella Blinman
BACKGROUND: Octogenarians represent a growing population reviewed in medical oncology clinics, yet there is a paucity of data on how chemotherapy is tolerated in this age group. AIM: To describe the use of palliative first-line chemotherapy in patients 80 years and over, and factors associated with its use. METHODS: We identified all new patients aged 80 years or older diagnosed with incurable advanced solid organ cancer, and seen in one of three Sydney medical oncology outpatient clinics between January 2009 and December 2013...
October 17, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27749001/association-of-type-2-diabetes-with-prolonged-hospital-stay-and-increased-rate-of-readmission-in-patients-with-lower-limb-cellulitis
#20
S M Wijayaratna, T Cundy, P L Drury, S Sehgal, S A Wijayaratna, F Wu
BACKGROUND/AIMS: Lower limb (LL) cellulitis related hospitalisations are prevalent in type 2 diabetes (T2DM) subjects. We assess its costs and factors associated with length of stay and readmissions. METHODS: A retrospective case-control study at an urban hospital servicing a multi-ethnic population in New Zealand, where 7% of the adult population is estimated to have diabetes. Admissions with LL cellulitis in 2008-2013 were identified using coding records. Subsequent hospitalisations after 1 month with the same diagnosis were classified as readmissions...
October 17, 2016: Internal Medicine Journal
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