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Internal Medicine Journal

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https://www.readbyqxmd.com/read/28636094/characterization-of-clonal-philadelphia-negative-cytogenetic-abnormalities-in-a-large-cohort-of-chronic-myeloid-leukemia
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28585259/antibiotic-complications-during-the-treatment-of-mycobacterium-ulcerans-disease-in-australian-patients
#13
Daniel P O'Brien, N Deborah Friedman, Andrew Hughes, Aaron Walton, Eugene Athan
BACKGROUND: Antibiotics are recommended first-line treatment for M. ulcerans disease. Antibiotic toxicity is common in Australian patients, yet antibiotic complication rates and their risk factors have not been determined. METHODS: An analysis of severe antibiotic complications was performed using data from a prospective cohort of M. ulcerans cases managed at Barwon Health from 1/1/1998-30/6/2016. A severe antibiotic complication was defined as an antibiotic adverse event that required its cessation...
June 6, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28560817/outcomes-of-pulmonary-arterial-hypertension-therapy-in-australia-is-monotherapy-adequate
#14
Avalon Moonen, Roger Garsia, Peter Youssef, Paul Torzillo, Tamera Corte, Christiane Boehm, Rachael Cordina, David Celermajer, Edmund Lau
BACKGROUND: In Australia, government-subsidised treatment of pulmonary arterial hypertension (PAH) is limited to monotherapy. Recent international guidelines advocate that initial combination therapy be considered for all symptomatic PAH patients. We sought to characterise "real-life" outcomes in PAH patients initiated on monotherapy. METHODS: We performed a retrospective analysis of 100 consecutive PAH patients at a single centre, who were commenced on monotherapy for PAH between 2004 and 2015...
May 31, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28560729/determining-the-factors-associated-with-blood-borne-virus-testing-of-substance-misusers-presenting-to-hospital
#15
Elaine Tennant, Ute Vollmer-Conna, Apo Demirkol, Jeffrey J Post
BACKGROUND: Diagnosing blood-borne virus (BBV) infection is an essential first step in eliminating transmission and securing access to treatment amongst substance misusers. AIMS: To determine the proportion of substance misusers presenting to hospital that have BBV testing performed and the factors influencing testing. METHODS: A retrospective cross-sectional study was performed of patients presenting to two Sydney teaching hospitals with substance misuse diagnoses between January and April 2015...
May 31, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28557368/a-strategic-framework-improves-access-to-stroke-reperfusion-across-the-state-of-victoria-australia
#16
Janet E Bray, Sonia Denisenko, Bruce C V Campbell, Michael Stephenson, Jason Muller, Grant Hocking Grad, Peter J Hand, Christopher F Bladin
BACKGROUND: In 2010, rapid access to stroke thrombolysis centres was limited in some regional areas in the Australian state of Victoria. These results, and in planning for Endovascular Clot Retrieval (ECR), have led to the implementation of strategies by the Victorian Stroke Clinical Network, the Victorian Stroke Telemedicine Program and local health services to improve state-wide access. AIMS: This study aims to examine whether access to stroke reperfusion services (thrombolysis and ECR) in regional Victoria have subsequently improved...
May 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28557364/supine-awake-oximetry-as-a-screening-tool-for-daytime-hypercapnia-in-super-obese-patients
#17
Yewon Chung, Frances Louise Garden, Adelle S Jee, Subash Srikantha, Saurabh Gupta, Peter Richard Buchanan, Peter Wallace Collett, Guy Barrington Marks, Hima Vedam
AIMS: To determine the validity of supine awake oximetry as a test for daytime hypercapnia and severe sleep disordered breathing in super-obese patients and to provide evidence to support its use as a screening tool for these disorders in this high-risk patient population. METHODS: Cross-sectional diagnostic test evaluation of super-obese adults (BMI >50 kg/m(2) ) presenting to Liverpool Hospital, Australia, between 2009 and 2015 for diagnostic polysomnography and arterial blood gas measurement...
May 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28544243/evening-versus-morning-dosing-regimen-drug-therapy-for-chronic-kidney-disease-patients-with-hypertension-in-blood-pressure-patterns-a-systematic-review-and-meta-analysis
#18
Caixia Wang, Yuqiu Ye, Chunyong Liu, Yongming Zhou, Linsheng Lv, Cailian Cheng, Shaomin Li, Tanqi Lou, Xun Liu
BACKGROUND: Evening dosing regimen drug therapy on blood pressure (BP) control is used widely, but its clinical benefits and preservation or re-establishment of normal 24-hour BP dipping pattern in chronic kidney disease (CKD) patients is not known. AIMS: To investigate the effect of evening dosing regimen of antihypertensive drugs on blood pressure patterns to CKD patients with hypertension. METHODS: We did a systematic review by searching PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference lists of relevant articles of published papers...
May 24, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28544061/survival-difference-according-to-mutation-status-in-a-prospective-cohort-study-of-australian-patients-with-metastatic-non-small-cell-lung-carcinoma-nsclc
#19
Lavinia Tan, Marliese Alexander, Ann Officer, Michael MacManus, Linda Mileshkin, Ross Jennens, Dishan Herath, Richard de Boer, Stephen B Fox, David Ball, Benjamin Solomon
BACKGROUND AND OBJECTIVE: Non-small cell lung cancer (NSCLC) is a heterogeneous disease comprising not only different histologic subtypes but also different molecular subtypes. Our objective is to describe the frequency of oncogenic drivers in patients with metastatic NSCLC, the proportion of patients tested and survival difference according to mutation status in a single-institution study. METHODS: Metastatic NSCLC patients enrolled onto a prospective Thoracic Malignancies Cohort (TMC) Study between July 2012 and August 2016 were selected...
May 24, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28516725/the-need-for-better-preventative-strategies-for-inflammatory-bowel-disease-patients-at-risk-of-herpes-zoster-virus
#20
William Bye, Miles Sparrow, Susie Connor, Jane Andrews, Katie Ellard, Watson Ng, Georgia Hume, Sally Antoniades, Alissa Walsh
BACKGROUND: Immunosuppressed IBD patients have an increased risk of HZV infection. The existing live-attenuated HZV vaccine is contraindicated in some of these patients and can only be used with caution in others. AIMS: To describe characteristics of IBD patients suffering HZV to enable implementation of risk mitigation strategies for those at highest risk. METHODS: Gastroenterologists completed a proforma for IBD patients who experienced HZV infection: IBD phenotype, details of HZV infection, immunosuppression and any change to treatment upon diagnosis of HZV...
May 17, 2017: Internal Medicine Journal
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