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Internal Medicine Journal

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https://www.readbyqxmd.com/read/29139173/incidence-of-in-hospital-and-post-discharge-diagnosed-hospital-associated-venous-thromboembolism-using-linked-administrative-data
#1
Joanne M Stubbs, Hassan Assareh, Jennifer Curnow, Kerry Hitos, Helen M Achat
BACKGROUND: Hospital-associated venous thromboembolism (HA-VTE) is a serious adverse event, preventable with appropriate care during and post admission. Accurate measurement of in-hospital and post-discharge incidences is essential for implementation and evaluation of prevention strategies and monitoring. AIMS: To estimate in-hospital and post-discharge diagnosed VTEs, trends and risk factors. METHODS: A population-based study in New South Wales, Australia using linked hospital admission and emergency department data for 2010-2013, amongst adult patients with a minimum stay of 48 hours...
November 15, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29136332/design-considerations-for-an-ehealth-decision-support-tool-in-inflammatory-bowel-disease-self-management
#2
Belinda D Jackson, Danny Con, Peter De Cruz
BACKGROUND: Electronic health (eHealth) decision support tools have the potential to: facilitate inflammatory bowel disease (IBD) self-management; reduce health care utilization, and; alleviate the pressure on over-burdened outpatient clinics. The purpose of this study was to explore the perspectives of key stakeholders on the potential use of a decision support tool for IBD patients. METHODS: A qualitative study using focus group methodology was conducted at a tertiary IBD center in Melbourne, Australia in February 2015...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#3
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29131479/measuring-the-success-of-medical-emergency-teams-potentially-preventable-deaths-versus-total-cardiac-arrest-deaths-a-single-centre-observational-study
#4
Jonathan Barrett, Gabrielle Hawdon, Julie Wade, John Reeves
Measuring the success of Medical Emergency Teams: Potentially preventable deaths versus total cardiac arrest deaths. A single centre observational study. BACKGROUND: Rapid response systems (RRS) have been implemented with the aim of preventing patient deterioration, in-hospital cardiac arrests (IHCA) and related deaths. Not all "unexpected deaths" are preventable, thus compromising the use of unexpected deaths as an outcome measure. AIMS: Our aim was to assess temporal trends in potentially preventable deaths as a subset of total unexpected death rates over a four-year period...
November 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29083111/risk-factors-associated-with-hypertensive-disorders-of-pregnancy-within-an-urban-indigenous-population-in-south-western-sydney
#5
Al Daly, N Sriram, C Woodall, K Selvakumar, K Briggs, P Garg, L Russell, M Yu, K Beetson, A Hennessy, Tharawal Ams
BACKGROUND: The prevalence of hypertensive disorders of pregnancy (HDP) in Australia's urban Indigenous women is unknown. AIM: To explore the risk factors associated with HDP for a cohort of urban Indigenous women in South-Western Sydney, Australia METHODS AND MATERIALS: This study was conducted in partnership with the Tharawal Aboriginal Medical Service (TAMS). Women (18-45 years) were recruited at the clinic and community events. The quantitative questionnaire included obstetric history, personal and family history of hypertension...
October 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29083080/underappreciation-of-non-alcoholic-fatty-liver-disease-by-primary-care-clinicians-limited-awareness-of-surrogate-markers-of-fibrosis
#6
Preya J Patel, Xuan Banh, Leigh U Horsfall, Kelly L Hayward, Fabrina Hossain, Tracey Johnson, Katherine A Stuart, Nigel N Brown, Nivene Saad, Andrew Clouston, Katharine M Irvine, Anthony W Russell, Patricia C Valery, Suzanne Williams, Elizabeth E Powell
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common cause of incidental liver test abnormalities. General practitioners have a key role in identifying people with NAFLD at risk of significant liver disease. Recent specialist guidelines emphasize the use of fibrosis algorithms or serum biomarkers rather than routine liver tests, to assess advanced fibrosis. This study evaluated primary care clinicians' current approach to diagnosis, management and referral of NAFLD. METHODS: A cross-sectional survey of primary care clinicians was undertaken through a structured questionnaire about NAFLD...
October 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29080286/evolve-the-australian-rheumatology-association-s-top-five-list-of-investigations-and-interventions-doctors-and-patients-should-question
#7
Kathleen Morrisroe, Ayano Nakayama, Jason Soon, Mark Arnold, Les Barnsley, Claire Barrett, Peter M Brooks, Stephen Hall, Patrick Hanrahan, Pravin Hissaria, Graeme Jones, Veera Srividya Katikireddi, Helen Keen, Rodger Laurent, Mandana Nikpour, Katherine Poulsen, Philip Robinson, Muriel Soden, Nigel Wood, Nicola Cook, Catherine Hill, Rachelle Buchbinder
BACKGROUND: The EVOLVE (evaluating evidence. enhancing efficiencies) initiative aims to drive safer, higher-quality patient care through identifying and reducing low-value practices. AIMS: To determine the Australian Rheumatology Association's (ARA's) 'top 5' list of low-value practices. METHODS: A working group comprising 19 rheumatologists and three trainees compiled a preliminary list. Items were retained if there was strong evidence of low-value and there was high or increasing clinical use and/or increasing cost...
October 28, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29068529/dealing-with-the-spiraling-price-of-medicines-issues-and-solutions
#8
REVIEW
Chun Kk Ma, Mark Danta, Richard Day, David Df Ma
Escalating cost of medicines is rapidly becoming a serious threat to patients and health systems. This trend has been documented to adversely impact patient outcomes. As clinicians and tax payers, it is our responsibility to be aware of the potential detrimental effects spiralling costs have on our patients, our community and our health system, and to mitigate these effects by exposing this issue to our respective professional societies, representatives of the pharmaceutical companies that we interact with, Government regulatory bodies, and to patients that we are caring for...
October 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29068514/high-incidence-of-aseptic-hip-necrosis-in-hodgkin-lymphoma-patients-treated-with-escalated-beacopp-receiving-methylprednisolone
#9
Sandra Basic-Kinda, Ivan Karlak, Nadira Durakovic, Zvonimir Ivan Lubina, Ivo Radman, Snježana Dotlic, Zinaida Peric, Ida Hude, Igor Aurer
BACKGROUND: Escalated BEACOPP (eBEACOPP) is an effective but fairly toxic regimen for treatment of Hodgkin lymphoma (HL). Avascular necrosis of femoral head (AVN) was previously reported to be increased in patients treated with eBEACOPP, but so far no systematic analysis of its frequency has been published. AIMS: We aimed to analyze frequency and identify possible risk factors for AVN development in patients treated with eBEACOPP. METHODS: We identified 26 patients treated with eBEACOPP for newly diagnosed high-risk advanced stage HL, 25 patients alive at the time of study...
October 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29068510/characteristics-of-adrenal-incidentalomas-in-a-new-zealand-centre
#10
Z Goh, I Phillips, P J Hunt, S Soule, T J Cawood
BACKGROUND: Management of adrenal incidentalomas (AI) is becoming more conservative, based on international data showing a low incidence of functional or malignant lesions. The clinical characteristics of AI in New Zealand are unknown. Therefore, whether the AI guidelines apply to the New Zealand population is also unknown. AIMS: To investigate the clinical characteristics of patients with AI presenting to a tertiary-care centre in New Zealand. METHOD: This study prospectively evaluated consecutive patients aged 18 or older with AI, 1 cm or larger, diagnosed in Canterbury, New Zealand...
October 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29034989/neurological-presentations-revealing-acquired-copper-deficiency-diagnosis-features-etiologies-and-evolution-in-seven-patients
#11
Aurélia Poujois, Nouzha Djebrani-Oussedik, Fabienne Ory-Magne, France Woimant
BACKGROUND: acquired copper deficiency (ACD) is a rare condition usually diagnosed from haematological changes. AIMS: characterize the diagnosis features and the evolution of patients with ACD revealed by neurological symptoms. METHODS: clinical, biological and MRI data were prospectively analysed at diagnosis and during follow-up under copper supplementation. RESULTS: seven patients were studied over a 5-year period...
October 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29034986/access-to-a-youth-specific-service-for-young-adults-with-type-1-diabetes-mellitus-is-associated-with-decreased-hospital-length-of-stay-for-diabetic-ketoacidosis
#12
Kharis Burns, Kaye Farrell, Rickie Myszka, Kris Park, Deborah Jane Holmes-Walker
BACKGROUND: Management of Type 1 diabetes mellitus (T1DM) in youth with diabetes is complex and glycaemic control often deteriorates during this challenging period. We hypothesise that attendance at a youth-specific diabetes clinic reduces hospital admission rates and length of stay for diabetic ketoacidosis (DKA). AIMS: This study aimed to assess the impact of a youth specific diabetes service for youth with diabetes (YWD) on DKA admissions in two adjacent local health districts (LHDs)...
October 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29034985/burden-of-atrial-fibrillation-in-m%C3%A4-ori-and-pacific-people-in-new-zealand-a-cohort-study
#13
Yulong Gu, Robert N Doughty, Ben Freedman, John Kennelly, Jim Warren, Matire Harwood, Richard Hulme, Chris Paltridge, Ruth Teh, Anna Rolleston, Natalie Walker
AIMS: Atrial fibrillation (AF) is a major risk factor for ischaemic stroke and cardiovascular events. In New Zealand (NZ), Māori (indigenous New Zealanders) and Pacific people experience higher rates of AF compared to non-Māori/non-Pacific people. This study describes a primary care population with AF in NZ. Stroke risk and medication adherence according to ethnicity are also detailed. METHODS: Electronic medical records for adults (≥20 years, n=135,840, including 19,918 Māori and 43,634 Pacific people) enrolled at 37 NZ general practices were analysed for AF diagnosis and associated medication prescription information...
October 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29024540/infections-resistance-patterns-and-antibiotic-use-in-patients-at-a-regional-cancer-centre
#14
Nivanka De Silva, Justin Jackson, Christopher Steer
AIMS: To document patient characteristics, infection types, patterns of antibiotic resistance and outcomes in all patients with cancer requiring inpatient management for suspected infection at a regional Australian cancer centre. METHODS: We studied patients ≥ 18 years of age who were admitted under the oncology unit at Albury Wodonga Health during a 12-month period and who had a microbiological test performed for suspected infection during their admission...
October 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29024333/united-we-stand-divided-we-conquer-pilot-study-of-multidisciplinary-general-medicine-heart-failure-care-program
#15
Omar Wahbi Izzettin, Ingrid Hopper, Edward Ritchie, Vathy Nagalingam, Ar Kar Aung
BACKGROUND: Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. AIMS: To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). METHODS: Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included...
October 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28980381/do-medical-oncology-patients-and-their-support-persons-agree-about-end-of-life-issues
#16
Amy Waller, Alix Hall, Rob Sanson-Fisher, Nicholas Zdenkowski, Charles Douglas, Justin Walsh
BACKGROUND: The perceptions of those called on to make decisions on behalf of patients who lack capacity at the end of life must accurately reflect patient preferences. AIMS: To establish the extent to which the views of medical oncology outpatients are understood by their support persons, specifically with regard to (i) preferred type and location of EOL care; (ii) preferred level of involvement in EOL decision making; and (iii) whether the patient has completed an advance care plan or appointed an enduring guardian...
October 5, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28967192/the-polyuria-polydipsia-syndrome-a-diagnostic-challenge
#17
REVIEW
Nicole Nigro, Mathis Grossmann, Cherie Chiang, Warrick J Inder
The main determinants for the maintenance of water homeostasis are the hormone arginine-vasopressin (AVP) and thirst. Disturbances in these regulatory mechanisms can lead to the polyuria-polydipsia syndrome, which comprises of three different conditions: central diabetes insipidus (DI) due to insufficient secretion of AVP, nephrogenic DI caused by renal insensitivity to AVP action, and primary polydipsia due to excessive fluid intake and consequent physiologic suppression of AVP. It is crucial to determine the exact diagnosis because treatment strategies vary substantially...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28967178/the-efficacy-of-azithromycin-and-doxycycline-treatment-for-rectal-chlamydial-infection-a-retrospective-cohort-study-in-south-australia
#18
Bin Li, Jane S Hocking, Peng Bi, Charlotte Bell, Christopher K Fairley
OBJECTIVE: To investigate treatment efficacy of two treatments for rectal chlamydial infection. METHODS: We performed a retrospective analysis of all patients diagnosed with rectal chlamydial infection between 2009 and 2015 in Adelaide, Australia. Patients were treated with either azithromycin (1 g single dose) or doxycycline (100 mg twice a day for 10 days) and returned for repeat testing 14 to 180 days after treatment commenced. Log binomial models were used to estimate the relative risk (RR) of recurrent rectal chlamydia associated with the treatment with azithromycin versus doxycycline...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28967175/patterns-of-care-and-outcomes-among-triple-negative-early-breast-cancer-patients-in-south-western-sydney
#19
Sayeda Naher, Annette Tognela, Eugene Moylan, Diana H Adams, Belinda E Kiely
AIM: We describe the patterns of care and outcomes of women with triple negative breast cancer (TNBC) treated at two cancer centres in Sydney, NSW, Australia, to help oncologists talk to women with this subtype of breast cancer about their likely prognosis. METHODS: We searched the electronic medical record for women with stage I to III, TNBC diagnosed from 2006 to 2014. For each woman we recorded demographics, tumour characteristics, treatment details, recurrences and survival using the Kaplan Meier method...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28967170/type-2-diabetes-in-young-adults-in-central-auckland-demography-and-complications
#20
Junaid Beig, Manish Khanolkar, Tim Cundy
BACKGROUND: Type 2 diabetes (T2D) in young adults is associated with a high risk of diabetes complications. AIMS: We investigated the demography and the emergence of complications of young adults with T2D in the central Auckland region where there has been substantial immigration. METHODS: 310 young adults with T2D (<40 years) were registered with the Auckland Diabetes Centre in 2015. We documented demographic, anthropometric and metabolic variables, prevalence and emergence of complications...
October 2, 2017: Internal Medicine Journal
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