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Internal Medicine Journal

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https://www.readbyqxmd.com/read/28707749/new-insights-into-sinusoidal-obstruction-syndrome
#1
Andrea Piccin, Maria Teresa Sartori, Gianni Bisogno, Muriel Van Schilfgaarde, Graziella Saggiorato, Angela Maria Di Pierro, Daisy Corvetta, Luigi Marcheselli, Mega Andrea, Günther Gastl, Simone Cesaro
We studied the relationships between endothelial extracellular vesicles (EV) and plasminogen-activator inhibitor type 1(PAI-1), to assess their modification in the early phase of sinusoidal obstruction syndrome (SOS). ENTRY CRITERIA: patients who developed SOS at single center from January 2000 to December 2011. SELECTION: patients who underwent hematopoietic stem cell transplantation (HSCT) or actinomicyn-based chemotherapy for nephroblastoma. PARTICIPANTS: the study group comprised 5 patients with SOS who were compared with a control group of 7 patients without SOS...
July 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28696571/acute-evaluation-of-the-acute-vestibular-syndrome-differentiating-posterior-circulation-stroke-from-acute-peripheral-vestibulopathies
#2
REVIEW
Benjamin Kwok-Tung Tsang, Alex Siew-Kar Chen, Mark Paine
This review article aims to provide an evidence-based approach to evaluating the patient who presents with acute prolonged, spontaneous vertigo in the context of the acute vestibular syndrome (AVS). Differentiation of posterior circulation stroke presenting as an acute vestibular syndrome has been regarded as an important diagnostic challenge for physicians involved in acute care. Current evidence suggests that a targeted approach to history taking and physical examination with emphasis on the oculomotor examination, more specifically the HINTS (Head Impulse/ Nystagmus/Test-of-skew) examination battery, yields a higher sensitivity for diagnosis of posterior circulation stroke than even standard magnetic resonance imaging with diffusion weighted imaging...
July 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28696562/association-between-nonalcoholic-fatty-liver-disease-and-peripheral-artery-disease-in-patients-with-type-2-diabetes
#3
Yaowu Zou, Xinde Li, Can Wang, Jing Wang, Fei Wang, Lidan Ma, Wenjun You, Changgui Li
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with risk of coronary heart diseases; however, the relationship between NAFLD and peripheral artery disease (PAD) in patients with type 2 diabetes has not been investigated. AIMS: To investigate the association between NAFLD and PAD in patients with type 2 diabetes patients. METHODS: We carried out a cross-sectional study in 2646 type 2 diabetes patients ≥ 40 years...
July 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28696520/delays-in-presentation-and-diagnosis-of-pulmonary-tuberculosis-a-retrospective-study-of-a-tertiary-health-service-in-western-melbourne-2011-2014
#4
Eloise Williams, Allen Cheng, Garry P Lane, Stephen David Guy
BACKGROUND: Effective tuberculosis (TB) control relies on early diagnosis and prompt treatment commencement. AIM: To investigate delays in presentation and diagnosis of pulmonary TB (PTB) in a low incidence setting in western Melbourne. METHODS: A single-centered retrospective observational cohort study of symptomatic patients ≥ 18 years newly diagnosed with PTB that were commenced on treatment between 1(st) December 2011 and 1(st) December 2014 at a tertiary teaching hospital in western Melbourne...
July 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28675669/a-two-year-audit-of-outcomes-of-pituitary-surgery-at-an-australian-teaching-hospital
#5
Timothy M E Davis, Imran Badshah, Jocelyn Drinkwater, Emily Kusich, Erin Latkovic, Neville Knuckey
BACKGROUND: There is evidence that cure rates and complications are influenced by the case load in neurosurgical centres performing transsphenoidal pituitary surgery. Although Australian centres may perform relatively small numbers of these procedures, there have been few published audits of their performance. AIMS: To conduct an audit of surgery for pituitary tumours between 2012 and 2014 in the only public hospital neurosurgical unit in the state of Western Australia...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28675639/prevalence-and-associations-of-psychological-distress-in-australian-junior-medical-officers
#6
Michelle W Lau, Wenlong Eric Li, Anthony Llewellyn, Allan M Cyna
AIMS: To determine the prevalence of psychological distress in Australian Junior Medical Officers (JMOs) and investigate the determinants associated with psychological distress over a three year (2014-2016) period. METHODS: JMOs were surveyed using the 2014-2016 JMO Census (n = 220, 399, and 466 each year, response rate approximately 15%). Levels of psychological distress were assessed using the Kessler Psychological Distress Scale (K10). A K10≥ 25 was chosen to indicate high psychological distress and this determinant was compared to various demographic and work-related factors...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28675622/early-radiological-intervention-and-haematology-screening-is-associated-with-excellent-outcomes-in-budd-chiari-syndrome
#7
Allison Mo, Adam Testro, Janine French, Marcus Robertson, Peter Angus, Andrew Grigg
BACKGROUND: Budd Chiari Syndrome (BCS) is a rare and life-threatening disorder, resulting from thrombosis of the hepatic veins. Various treatments including pharmacological, radiological and surgical interventions have been used. AIM: We aimed to retrospectively describe our institution's experience with management of patients with BCS. RESULTS: Between 2000 and 2012, 27 patients with primary BCS presented with a median Rotterdam score of 1...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28675538/the-frequency-and-risk-factors-of-colorectal-adenoma-in-patients-with-early-gastric-cancer
#8
Hyun Hee Chung, Kyeong Ok Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
BACKGROUND/AIMS: The authors aimed to determine the clinical value of colonoscopy by evaluating the frequency of colorectal neoplasm detection in patients with early gastric cancer (EGC) as compared with healthy controls and analyzed the risk factors of advanced colorectal neoplasm in patients with EGC. METHODS: The medical records of 201 patients diagnosed as EGC and age and gender matched healthycontrols were retrospectively reviewed. Frequencies and clinical features of colorectal polyps of patients and controls were compared...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28636094/characterization-of-clonal-philadelphia-negative-cytogenetic-abnormalities-in-a-large-cohort-of-chronic-myeloid-leukemia
#9
Xiangjun Chen, Jine Zheng, Kaiwei Liang, Yanli He, Wen Du, Juan Li, Wei Liu, Yanjie Hu, Junxia Yao
OBJECTIVES: Clonal Philadelphia-negative Cytogenetic Abnormalities (CPCA) have been reported in chronic myeloid leukaemia (CML) patients treated with either interferon or tyrosine kinase inhibitor (TKI). However, the incidences and types of these cytogenetic abnormalities after treatment vary due to the limited populations enrolled. METHODS: We analysed the frequency and types of CPCA in a cohort of 607 CML patients in the chronic phase after TKI treatment. We also followed up these CPCA with a median of 31...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28635149/underuse-of-risk-assessment-and-overuse-of-ctpa-in-patients-with-suspected-pulmonary-thromboembolism
#10
Michael Perera, Leena Aggarwal, Ian A Scott, Nicholas Cocks
INTRODUCTION: Evidence suggests potential overuse of computerised tomography pulmonary angiography (CTPA) in patients with suspected pulmonary thromboembolism (PTE) in the absence of consistent use of pre-test clinical prediction rules and D-dimer assays. METHODS: 344 consecutive patients undergoing CTPA at a tertiary hospital were studied for use of D-dimer assays and clinical prediction rules for PTE. For each patient, a modified Wells score (mWS), revised Geneva score (rGS) and PISA model were calculated retrospectively; performance characteristics for each rule for PTE were determined in reference to results of CTPA...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#11
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28632340/prescribing-in-the-oldest-old-inpatients-a-retrospective-analysis-of-patients-referred-for-specialist-geriatric-consultation
#12
Sivarajah Ilango, Peter Pillans, Nancye M Peel, Ian Scott, Leonard C Gray, Ruth E Hubbard
INTRODUCTION: While medications may prolong life and prevent morbidity in older people, adverse effects of polypharmacy are increasingly recognised. As patients age and become frail, prescribing may be expected to focus more on symptom control and minimise potentially harmful preventive medication use that confer little benefit within a short lifespan. Whether prescribing practice shifts to one of symptom control among the oldest old admitted to hospital remains unclear. METHODS: Retrospective analysis of all patients aged ≥85 years referred for comprehensive geriatric assessment at a tertiary care hospital between May 2006 and December 2014 for whom all prescribed medications were documented...
June 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28628276/acute-myeloid-leukaemia-relapsing-after-allogeneic-haematopoietic-stem-cell-transplantation-prognostic-factors-and-impact-of-initial-therapy-of-relapse
#13
Andrew B M Lim, Cameron Curley, Chun Yew Fong, Ian Bilmon, Ashanka Beligaswatte, Duncan Purtill, Bartlomiej Getta, Anne Maree Johnston, Tasman Armytage, Marnie Collins, Kate Mason, Katherine Fielding, Matthew Greenwood, John Gibson, Mark Hertzberg, Matthew Wright, Ian Lewis, John Moore, David Curtis, Jeff Szer, Glen Kennedy, David Ritchie
AIMS: We sought to determine factors associated with overall survival from relapse (OSR) of acute myeloid leukaemia (AML) after allogeneic haematopoietic stem cell transplantation (alloHSCT), and the effect of first salvage therapy and subsequent GVHD on OSR. METHODS: Data on 386 patients from nine Australian centres with relapsed AML post-alloHSCT were collected retrospectively. OSR was calculated using the Kaplan-Meier method. Univariate and multivariate analyses were conducted using the logrank test and proportional hazards modelling respectively, and a prognostic index for OSR was derived from multivariate modelling...
June 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28608512/commencement-of-cardioselective-beta-blockers-during-hospitalisation-for-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#14
Pieter A Neef, Louise M Burrell, Christine F McDonald, Louis B Irving, Douglas F Johnson, Daniel P Steinfort
BACKGROUND: In patients with chronic obstructive pulmonary disease (COPD) and comorbid cardiovascular disease emerging evidence suggests a benefit in commencing cardioselective beta-blockers. AIM: Our objective was to determine the safety of beta-blocker commencement during hospitalisation for acute exacerbation of COPD. METHODS: A retrospective cohort study of 1,071 patients hospitalised for acute exacerbation of COPD was conducted across two tertiary hospitals over a 12-month period...
June 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28608499/clinical-benefit-of-eculizumab-in-patients-with-no-transfusion-history-in-the-international-paroxysmal-nocturnal-haemoglobinuria-registry
#15
A M Almeida, C Bedrosian, A Cole, P Muus, H Schrezenmeier, J Szer, W F Rosse
BACKGROUND: Eculizumab reduces intravascular haemolysis and improves disease symptoms in patients with paroxysmal nocturnal haemoglobinuria (PNH). AIMS: To characterize, in a real-world setting, effect of eculizumab in patients with haemolytic PNH (LDH ≥1.5 ULN) and no history of red blood cell transfusion, including those with high disease activity (HDA). METHODS: Three populations from the International PNH Registry were studied: 1) non-transfused, untreated, 2) non-transfused, eculizumab-treated, 3) transfused, eculizumab-treated (≥1 transfusions in 6 months prior to eculizumab initiation)...
June 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28589690/perioperative-management-of-new-oral-anticoagulants-in-patients-undergoing-elective-surgery-at-a-tertiary-hospital
#16
Henry Wamala, Ian A Scott, Xenia Caney
BACKGROUND: Increasing numbers of patients receiving new oral anticoagulants (NOACs) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. METHODS: Retrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between January 1(st) 2014 and June 30(th) 2015 and were receiving NOACs for at least 3 months prior to surgery...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28589641/the-yield-of-head-computed-tomography-in-patients-with-new-onset-of-transient-headaches
#17
Niamh Hammond, Annemarei Ranta
BACKGROUND: Headache is a common patient complaint. The threshold for brain imaging in headache is debated, especially when the headache is transient, although even if the headache has resolved at presentation a sentinel bleed heralding a subarachnoid haemorrhage (SAH) often remains a concern. AIMS: To assess the yield of computed tomography (CT) head scan referrals for patients with transient headache symptoms. METHODS: This study looked at six months of CT results assessing for brain pathology with a particular focus on subarachnoid haemorrhage...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28589617/recording-patient-body-weight-in-hospitals-are-we-doing-well-enough
#18
REVIEW
Kate Flentje, Colin Knight, Ingrid Stromfeldt, Anindita Chakrabarti, N Deborah Friedman
Recording patient weight is a standard practice for all hospital admissions, with this measurement influencing other daily practices that rely on the delivery of safe and effective patient care. Patient weight is important in the areas of medication prescribing, fluid balance and assessment of nutrition. In particular, prescribing narrow therapeutic index medications may result in significant harm as a potential consequence of inaccurate dosing. Despite its importance, it is evident that body weight measurements are recorded in only 13...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28585274/junior-doctors-attitudes-to-opioids-for-refractory-breathlessness-in-patients-with-advanced-chronic-obstructive-pulmonary-disease
#19
Natasha Smallwood, Nicole Gaffney, Alexandra Gorelik, Louis Irving, Brian Le, Jennifer Philip
Refractory breathlessness is a common, distressing symptom in patients with advanced chronic obstructive pulmonary disease (COPD). The judicious, off-licence prescription of opioids, together with other management strategies, can improve breathlessness, however, internationally there is profound reluctance to prescribe opioids for breathlessness in COPD. AIMS: To understand Australian junior doctors' knowledge and attitudes regarding the management of refractory breathlessness and the role of opioids in COPD...
June 6, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28585273/direct-access-colonoscopy-impact-of-intervention-on-time-to-colorectal-cancer-diagnosis-and-treatment-in-north-west-tasmania
#20
Penny Allen, Lucy Gately, Patricia Banks, Adrian Y S Lee, Garry Hamilton, Lavinia Tan, Sheryl Sim
BACKGROUND: Direct access colonoscopy (DAC) allows general practitioners to refer directly for colonoscopy, without specialist review. Research suggests DAC reduces times to diagnosis and treatment of colorectal cancer. However, there is no information about outcomes of DAC in Australia. AIMS: To determine if Direct Access Colonoscopy (DAC) in North-West Tasmania expedited colorectal diagnosis and treatment. METHODS: Pre-post intervention study evaluating time from referral to diagnosis and definitive treatment...
June 6, 2017: Internal Medicine Journal
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