Internal medicine journal
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Internal medicine journal · Jan 2012
Childhood asthma and GOLD-defined chronic obstructive pulmonary disease.
Current understanding of chronic obstructive pulmonary disease (COPD) is that it results from an interaction of genetic and environmental factors. This study aimed to investigate the strength of association of various known risk factors for COPD. ⋯ Childhood asthma emerged with the strongest association for GOLD-defined COPD. Possible explanations for this are suggested, including limitations of the current GOLD spirometric definition of COPD, a chance observation because of the high prevalence of both disorders in this population, or alternatively childhood asthma is a risk factor for COPD.
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Internal medicine journal · Jan 2012
Clinical TrialSimple approach to improving vancomycin dosing in intensive care: a standardised loading dose results in earlier therapeutic levels.
Patients in the Intensive Care Unit (ICU) often have sub-therapeutic vancomycin levels in the initial stages of therapy. Loading doses have been demonstrated to overcome this problem. ⋯ A standardised loading dose is a simple and sustainable intervention that may improve early achievement of therapeutic vancomycin levels in critically ill patients. The clinical significance of this requires further study.
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Internal medicine journal · Jan 2012
Multicenter StudyTransfer from residential aged care to emergency departments: an analysis of patient outcomes.
In order to design optimal systems to meet the acute healthcare needs of the frail elderly living in residential care, good clinical information is essential. The aims of this study were to analyse the casemix and outcomes of patients transferred from residential aged care facilities to public hospital emergency departments in New South Wales. ⋯ Patients transferred from aged care facilities to emergency departments are predominantly high-acuity patients with a substantial likelihood of hospitalisation, intervention and death. Nevertheless, scope exists for some episodes of acute care, in both discharged and admitted patients, to be provided outside a hospital setting.
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Internal medicine journal · Jan 2012
Managing acute medical admissions: a survey of acute medical services and medical assessment and planning units in New Zealand.
To determine the current provision of acute medical services, including the development of medical assessment and planning units (MAPUs), by district health boards (DHBs) throughout New Zealand (NZ). ⋯ Medical assessment and planning units have become an important component of acute medical service provision in NZ. The established units largely comply with Australasian recommendations, although important deficiencies exist. Training of physicians must combine the needs of acute medical patients and clinical roles of physicians within MAPUs with local DHB requirements for services to be most effective.
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Internal medicine journal · Jan 2012
Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up.
Takotsubo cardiomyopathy (TC) is increasingly recognised in patients presenting with features of acute coronary syndrome. We present a single centre experience of TC with medium term follow up. ⋯ While TC is a reversible condition with low rates of complications and recurrence at follow up it is, as demonstrated in our cohort, associated with significant in-hospital morbidity in a proportion of patients.