Internal medicine journal
-
Internal medicine journal · May 2012
Stroke management: updated recommendations for treatment along the care continuum.
The Australian Clinical Guidelines for Stroke Management 2010 represents an update of the Clinical Guidelines for Stroke Rehabilitation and Recovery (2005) and the Clinical Guidelines for Acute Stroke Management (2007). For the first time, they cover the whole spectrum of stroke, from public awareness and prehospital response to stroke unit and stroke management strategies, acute treatment, secondary prevention, rehabilitation and community care. The guidelines also include recommendations on transient ischaemic attack. The most significant changes to previous guideline recommendations include the extension of the stroke thrombolysis window from 3 to 4.5 h and the change from positive to negative recommendations for the use of thigh-length antithrombotic stockings for deep venous thrombosis prevention and the routine use of prolonged positioning for contracture management.
-
Internal medicine journal · May 2012
Proton pump inhibitors and diarrhoea related to Clostridium difficile infection in hospitalised patients: a case-control study.
The incidence and disease severity of Clostridium difficile infection are rising. There is increasing evidence of a potential association between proton-pump inhibitors (PPI) and C. difficile infection. ⋯ A restricted analysis on those who had exposure to antibiotics within 3 months before the onset of diarrhoea did not change the negative association between PPI exposure and PCR-proven C. difficile infection. Long-term PPI usage and intensity of PPI exposure prior to onset of diarrhoea were not significantly associated with C. difficile infection.
-
Internal medicine journal · May 2012
Case ReportsUtility of atrial temporary pacing as an acute treatment for bradyarrhythmias and tachyarrhythmias in the intensive care setting with preservation of atrioventricular synchrony.
Temporary pacing is often used as an acute treatment of bradyarrhythmias and suppression of tachyarrhythmias. In patients with cardiogenic shock, loss of atrioventricular synchrony may worsen cardiovascular haemodynamics. We present a series where temporary right atrial pacing was used as an acute treatment for both bradyarrhythmias and tachyarrhythmias.