Internal medicine journal
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Internal medicine journal · Apr 2012
Meta AnalysisAngiotensin-converting enzyme gene insertion/deletion polymorphism and essential hypertension in the Chinese population: a meta-analysis including 21,058 participants.
The angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been suggested to influence susceptibility to essential hypertension (EH), but the results of many individual studies are conflicting. ⋯ In the whole Chinese population, the D allele was significantly linked with EH susceptibility. However, the relation between the I/D polymorphism and EH is still inconclusive in some national minorities and must await larger scale studies.
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Although previous academic performance is acknowledged as the best predictor of achievement in medical school, no one has succeeded in finding a selection method which will choose students who will become doctors with the qualities the community expect. Australian medical schools use various selection methods. It could well be argued that the most important phase in the selection process is informed decision-making by potential applicants. More effort should be made by medical schools to achieve this.
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Internal medicine journal · Apr 2012
Comparative StudyDifferences in characteristics of men with localised prostate cancer who demonstrate low, intermediate or high prostate-specific antigen velocity.
Current diagnostic tools are inadequate for reliable prediction of prostate cancer (PCa) aggressiveness in patients with localised disease. This results in many patients being exposed to potentially unnecessary invasive treatment and its associated morbidities. In order to develop appropriate treatment strategies, it is essential to understand the differences between patients who will develop aggressive disease and those who will not. ⋯ These findings highlight the role of aspirin and smoking in PCa progression. They have potential towards risk stratification as well as PCa prevention and hence need to be investigated further.
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Internal medicine journal · Apr 2012
A 5-year follow up of patients discharged with non-specific abdominal pain: out of sight, out of mind?
Acute non-specific abdominal pain (NSAP) is prevalent in 6-25% of the general population and is a common cause of admission to the emergency department (ED). Despite involvement of substantial financial and human resources, there are few data on long-term outcome after initial diagnosis. The aim of this study was to evaluate long-term outcome of patients initially admitted with NSAP to an ED. ⋯ The long-term impact for patients initially admitted to our ED with acute NSAP is significant--28% of patients continue to suffer from recurring NSAP after 5 years. NSAP therefore remains, despite more advanced diagnostic tools, a true and, as yet, unsolved problem.
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Internal medicine journal · Apr 2012
Comparative StudyDiagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration compared with transbronchial and endobronchial biopsy for suspected sarcoidosis.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate and minimally invasive technique that has been shown to have excellent diagnostic yield in the investigation of mediastinal and hilar lymphadenopathy. There is, however, little evidence comparing this procedure to the traditional diagnostic approach of transbronchial lung (TBLB) and endobronchial (EB) biopsies combined with characteristic clinical and radiological features in sarcoidosis. ⋯ Endobronchial ultrasound-guided transbronchial needle aspiration alone has a high diagnostic yield with a very low complication rate for patients with suspected sarcoidosis.