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Internal Medicine Journal

M Elizabeth Wilcox, Andrew S Lim, Ruxandra Pinto, Sandra E Black, Mary Pat McAndrews, Gordon D Rubenfeld
BACKGROUND: Few studies have investigated sleep in patients after intensive care despite the possibility that inadequate sleep might further complicate an acute illness impeding recovery. AIMS: Our objectives were to assess the quality and quantity of a patients' sleep on the ward by polysomnography (PSG) within a week of intensive care unit (ICU) discharge and to explore the prevalence of key in-ICU risk factors for persistent sleep fragmentation. METHODS: We enrolled twenty patients after they have been mechanically ventilated for at least 3 days and survived to ICU discharge...
March 9, 2018: Internal Medicine Journal
Wendy A Davis, Kirsten E Peters, Ashley Makepeace, Shaye Griffiths, Christine Bundell, Struan F A Grant, Sian Ellard, Andrew T Hattersley, S A Paul Chubb, David G Bruce, Timothy Me Davis
BACKGROUND: Accurate diabetes prevalence estimates are important for health service planning and prioritisation. Available data have limitations, suggesting that the contemporary burden of diabetes in Australia is best assessed from multiple sources. AIMS: To use systematic active detection of diabetes cases in a postcode-defined urban area through the Fremantle Diabetes Study Phase II (FDS2) to complement other epidemiological and survey data in estimating the national prevalence of diabetes and its types...
March 7, 2018: Internal Medicine Journal
Jessica O'Brien, Akshat Saxena, Christopher M Reid, Lavinia Tran, Robert Baker, Andrew Newcomb, Julian Smith, Molla M Huq, Stephen J Duffy
BACKGROUND: Indigenous Australians have higher rates of cardiovascular disease and co-morbidities compared to their non-Indigenous counterparts. AIMS: We sought to evaluate whether Indigenous status per se portends a worse prognosis following isolated coronary artery bypass grafting (CABG). METHODS: The outcomes of 778 Indigenous Australians (55±10 years; 32% female) enrolled in the Australian and New Zealand Society of Cardiac and Thoracic Surgeons registry were compared to 36,124 non-Indigenous Australians (66±10 years; 21% female) following isolated CABG...
March 7, 2018: Internal Medicine Journal
Linda S Yang, Sumaya Alukaidey, Katherine Croucher, Damian Dowling
BACKGROUND: Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both pro-coagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. AIM: We aim to assess the rate of pharmacological prophylaxis for VTE among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld...
February 21, 2018: Internal Medicine Journal
Anna Wood, David O'Neal, John Furler, Elif I Ekinci
The advent of devices that can track interstitial glucose levels which are closely related to blood glucose levels on a near continuous basis has facilitated better insights into patterns of glycaemia. Continuous glucose monitoring (CGM) therefore allows for more intensive monitoring of blood glucose levels and potentially improved glycaemic control. In the context of the announcement on 1 April 2017 that the Australian Government will fund CGM monitoring for people with type 1 diabetes under the age of 21, this paper provides a review of the evidence for CGM and some of the ongoing challenges...
February 21, 2018: Internal Medicine Journal
Susannah Ward, Sue Outram, Ben Heslop
BACKGROUND: We conducted a pilot project assessing the perceived utility and relevance of wellbeing sessions provided to interns at a large regional teaching hospital in Australia with the aim of promoting intern wellbeing and fostering a nurturing and supportive learning and work hospital culture. METHOD: Our intervention involved two separate 60 minute lectures covering wellbeing topics and skills, to approximately 50 interns within protected teaching time, along with emailed wellbeing resources...
February 21, 2018: Internal Medicine Journal
Ying Bai, Ying Zhao, Jie Li, Ying Zhang, Rong Bai, Xin Du, Jian-Zeng Dong, Yi-Hua He, Chang-Sheng Ma
BACKGROUNDS AND OBJECTIVES: Strain was shown associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA), but data on AF patients complicated with chronic lung diseases (CLDs) were rare. This study was designed to evaluate the relationship of baseline atrial function with AF recurrence in these patients using speckle-tracking echocardiography. METHODS AND RESULTS: Average strain values (median: 2 days before RFA) were calculated for 87 AF patients (Mean age: 61...
February 20, 2018: Internal Medicine Journal
Lisa Gillinder, Alexander Lehn, Helen Brown, Sasha Dionisio
OBJECTIVE: The present study aims to determine qualitative outcomes of presentations with acute recurrent seizures or status epilepticus to the emergency department of our institution after the introduction of a new seizure management protocol METHODS: We performed a retrospective analysis on two cohorts of patients for all presentation to the emergency department of our institution. Presentations were reviewed from January to July pre protocol introduction and the same period post protocol...
February 20, 2018: Internal Medicine Journal
Jun Jiang, Lan Lei, Xiaowan Zhou, Peng Li, Ren Wei
BACKGROUND: Recent studies have shown that low hemoglobin (Hb) level promote the progression of chronic kidney disease. This study assessed the relationship between Hb level and type 1 diabetic nephropathy (DN) in Anhui Han's patients. METHODS: There were a total of 236 patients diagnosed with type 1 diabetes mellitus and (T1DM) seen between January 2014 and December 2016 in our centre. Hemoglobin levels in patients with DN were compared with those without DN. The relationship between Hb level and the urinary albumin-creatinine ratio (ACR) was examined by Spearman's correlational analysis and multiple stepwise regression analysis...
February 20, 2018: Internal Medicine Journal
Ronpichai Chokesuwattanaskul, Charat Thongprayoon, Konika Sharma, Soontharee Congrete, Tanyanan Tanawuttiwat, Wisit Cheungpasitporn
BACKGROUND/OBJECTIVES: The strong relationship between sleep apnea and atrial fibrillation (AF) is well-known. However, it remains unclear whether the sleep quality are related with AF. We performed this systematic review and meta-analysis to evaluate the associations of sleep duration, insomnia and frequent awakening with AF. METHODS: A systematic review was conducted in MEDLINE, EMBASE, Cochrane databases from inception through September 2017 to identify studies that evaluate the risk of AF in adults with short sleep duration, long sleep duration, insomnia, and/or frequent awakening...
February 20, 2018: Internal Medicine Journal
Julia E Shrosbree, Grahame J Elder, John A Eisman, Jacqueline R Center
BACKGROUND: Osteoporosis is highly prevalent in the heart and lung transplant population. Given high rates of concurrent renal impairment, there is increasing use of denosumab in this population. However, denosumab may be associated hypocalcaemia, particularly in patients with chronic kidney disease (CKD). AIM: This study sought to explore the risk of hypocalcaemia in a heart and lung transplant cohort prescribed denosumab for osteoporosis. METHODS: We performed a retrospective database review of all surviving heart and lung transplant recipients who had received denosumab for osteoporosis between January 2012 and November 2015...
January 24, 2018: Internal Medicine Journal
Joanna Tieu, Paul Hakendorf, Richard J Woodman, Karen Patterson, Jenny Walker, Peter Roberts-Thomson
AIM: Semi-quantitative wide-field nailfold capillaroscopy (NFC) is a simple technique with proven utility in the early diagnosis of systemic sclerosis (SSc). Its role in prognosis, however, remains uncertain. This studyseeks to investigate the possible utility of NFC in predicting survival. METHODS: Patients with SSc listed on the South Australian Scleroderma Register (SASR) with prior NFC performed at Flinders Medical Centre from 1991 to 2015 were included in this study...
January 24, 2018: Internal Medicine Journal
Jeremy D Brown
BACKGROUND: Many Australian patients are diagnosed and treated for the scientifically and politically controversial diagnosis of an endemic form of 'Australian Lyme Disease'. Patient advocacy led Senator John Madigan to propose an Australian Senate Inquiry into this illness. AIMS: To describe the symptomology and outcomes of patients diagnosed and treated with Lyme disease in Australia. METHODS: All public, first-person submissions (n = 698) to the inquiry were reviewed and responses analysed for epidemiology, symptoms and impact against structured criteria...
January 24, 2018: Internal Medicine Journal
Nicholas Myles, Jacoba von Wielligh, Mario Kyriacou, Terry Ventrice, Luen Bik To
OBJECTIVES: to estimate the reduction in blood volume loss and diagnostic test quality associated with introduction of small volume blood tubes in a cohort of haematology inpatients compared to a historical comparator group. DESIGN: prospective cohort study. SETTING: haematology unit of a tertiary referral hospital in Adelaide. PARTICIPANTS: haematology inpatients. INTERVENTION: small volume blood tubes were used in an intervention cohort admitted between 2012-2013 and compared to a control cohort admitted between 2009-2010 where standard volume tubes had been used...
January 24, 2018: Internal Medicine Journal
Emma Jane Bishop, Ravindranath Tiruvoipati, Julie Metcalfe, Catherine Marshall, John Botha, Peter G Kelley
BACKGROUND: Tigecycline is a third-line therapy for severe Clostridium difficile infection (CDI) in Australasian guidelines. Differences in strain types make it difficult to extrapolate international tigecycline efficacy data with combination or monotherapy to Australian practice, where experience is limited. AIMS: To evaluate the efficacy and adverse effects associated with tigecycline combination therapy for severe and severe-complicated CDI in an Australian health care setting...
January 24, 2018: Internal Medicine Journal
Samuel Al Hall, Abdul Shaikh, KailinTeh, Mahsa Tantiongco, Douglas Coghlan, Chris S Karapetis, Mohammad A Chinnaratha, Richard Woodman, Kate R Muller, Alan J Wigg
Background and Aims International guidelines recommend screening for Hepatitis B virus (HBV) infection prior to administration of rituximab, due to high risk of HBV reactivation in at risk patients. The aim of this study was to determine; (1) adherence to the South Australian (SA) protocol for HBV screening, (2) HBV prevalence in patients receiving rituximab, and (3) outcomes of patients at risk of HBV reactivation. METHODS: All patients commenced on rituximab at the 6 major SA public hospitals during a 12-month period were included in the study...
January 18, 2018: Internal Medicine Journal
Sally de Boer, Christopher A Lewis, Wendy Fergusson, Kevin Ellyett, Margaret L Wilsher
Background and aims This study evaluated whether there are ethnic factors which affect the severity and progression of bronchiectasis in our adult multi-ethnic population in Auckland, New Zealand. METHODS: Clinical records were reviewed from patients attending the outpatient facilities of our institution between 2007 and 2010. Data collected included demographics, clinical features, smoking status, self-reported ethnicity, socioeconomic status (NZDep), pulmonary function and sputum microbiology...
January 18, 2018: Internal Medicine Journal
J Fyson, L Chapman, M Tatton, Z Raos
Goals To evaluate the effect of a Standardised Procedure Checklist (PC) and Equipment Kit (EK) on procedural quality and complication rates for abdominal paracentesis. BACKGROUND: Paracentesis is a common invasive procedure performed by junior doctors. Audit of procedure conduct at two New Zealand hospitals in 2012 revealed poor performance across a range of quality measures including documentation of informed consent, excessive catheter dwell times, and inappropriate albumin prescription...
January 18, 2018: Internal Medicine Journal
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
John Mackintosh, Grace Cone, Kate Harland, Krishna B Sriram
BACKGROUND: Patient anxiety is an often overlooked complication of pleural diagnostic and therapeutic procedures. Listening to music is effective in reducing patient anxiety in some endoscopy procedures but has not yet been evaluated in pleural procedures. METHODS: Consecutive patients undergoing therapeutic pleural procedures were randomised to music and control groups. Participants in the music group listened to self selected music using ear-bud headphones for the duration of the procedure...
January 18, 2018: Internal Medicine Journal
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