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Internal Medicine Journal

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https://www.readbyqxmd.com/read/28019080/breast-and-ovarian-cancer-referrals-to-the-act-genetic-service-are-we-meeting-guidelines
#1
Lucy Aitken, Linda Warwick, Alison Davis
BACKGROUND: The ACT Genetic Service at The Canberra Hospital evaluates the genetic risk of individuals for inherited diseases, and provides counselling and genetic testing where appropriate. AIMS: To evaluate the current referral practice for patients with a personal and/or family history of breast and/or ovarian cancer, and to assess whether these referrals are made according to eviQ cancer referral guidelines. METHODS: A retrospective clinical audit of patients seen by the ACT Genetic Service for evaluation of genetic risk of breast and/or ovarian cancer between 1(st) January 2013 and 30(th) June 2015...
December 26, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/28019068/using-iron-studies-to-predict-hfe-mutations-in-new-zealand-implications-for-laboratory-testing
#2
Rebecca O'Toole, Kenneth Romeril, Collette Bromhead
BACKGROUND: The diagnosis of Hereditary Haemochromatosis (HH) is not straightforward since symptoms are often absent or non-specific. Biochemical markers of iron-overloading, may be affected by other conditions. This study measured the correlation between iron studies and HFE genotype to inform evidence-based recommendations for laboratory testing in NZ. METHODS: Results from 2388 patients genotyped for C282Y, H63D and S65C in Wellington NZ from 2007- 2013 were compared to their biochemical phenotype as quantified by SF, transferrin saturation (TS), serum iron (SI) and serum transferrin (ST)...
December 26, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27928875/is-it-all-about-price-why-requests-for-government-subsidy-of-anticancer-drugs-were-rejected-in-australia
#3
Deme John Karikios, Lesley Chim, Andrew Martin, Adnan Nagrial, Kirsten Howard, Glenn Salkeld, Martin Richard Stockler
BACKGROUND: Australians access anticancer drugs predominantly through the Pharmaceutical Benefits Scheme (PBS). We aimed to determine why the Pharmaceutical Benefits Advisory Committee (PBAC) rejects submissions to list anticancer drugs on the PBS. METHODS: We reviewed publicly available information about submissions made to the PBAC for PBS listing of anticancer drugs from 2005 to 2014. Submission characteristics including clinical and economic evidence, PBAC recommendations, and the reasons offered for rejection were recorded...
December 8, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27925427/spleen-australia-guidelines-for-the-prevention-of-sepsis-in-patients-with-asplenia-and-hyposplenism-in-australia-and-new-zealand
#4
REVIEW
Kudzai Kanhutu, Penelope Jones, Allen C Cheng, Louise Grannell, Emma Best, Denis Spelman
People with asplenia or hyposplenism are at increased risk of fulminant sepsis which carries a high mortality rate. A range of preventive measures are recommended although there is ongoing evidence that knowledge of and adherence to these strategies is poor. There have been significant changes in recommended vaccinations since the previously published recommendations in 2008. We provide current recommendations to help Australian and New Zealand clinicians in the prevention of sepsis in patients with asplenia and hyposplenia...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27925382/moving-beyond-not-enough-time-factors-influencing-paediatric-clinicians-participation-in-research
#5
Simon Paul Paget, Patrina Hy Caldwell, Joyce Murphy, Kimberley J Lilischkis, Angie M Morrow
BACKGROUND: Increasing the amount of clinical research that occurs in healthcare settings has been identified as an important mechanism to improve healthcare outcomes. While clinicians are key persons in achieving this aim, research participation amongst clinicians is generally limited. AIMS: To identify the factors (barriers and facilitators) influencing clinician research participation and determine how professional culture impacts on these factors. METHODS: Forty clinicians working at a tertiary children's hospital participated in six discipline-specific focus groups...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27925381/doctors-use-of-mobile-devices-in-the-clinical-setting-a-mixed-methods-study
#6
Arany Nerminathan, Amanda Harrison, Megan Phelps, Karen M Scott
AIM: To explore how doctors use mobile devices in the clinical setting and understand drivers for use. METHODS: A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. RESULTS: The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting...
December 7, 2016: Internal Medicine Journal
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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/27761992/obesity-and-hypertension-in-australian-young-people-results-from-the-australian-health-survey-2011-to-2012
#17
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/28076917/multi-organ-dysfunction-due-to-bath-salts-are-we-aware-of-this-entity
#18
Rohith Valsalan, Benoj Varghese, Diya Soman, Jonathan Buckmaster, Steven Yew, David Cooper
Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. This case highlights that even though a urine drug screen for routine psychostimulant drugs is negative, clinicians need to be vigilant about the adverse effects of MDPV as a possible cause of multi-organ dysfunction...
January 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28076916/false-positive-hepatitis-b-virus-core-and-surface-antibodies-due-to-intravenous-immunoglobulin
#19
LETTER
Nicola Benwell, Peter Boan, Edward Raby, Ben McGettigan
No abstract text is available yet for this article.
January 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28076915/towards-equality
#20
EDITORIAL
Phillippa Poole
No abstract text is available yet for this article.
January 2017: Internal Medicine Journal
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