Internal medicine journal
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Recent trials within the past few years have influenced not only how we treat patients immediately after acute ischaemic stroke, but also how we investigate for aetiology. With the advent of improved medications, procedures and monitoring devices, modern stroke prevention strategies are more individualised, but the decision-making process is more complex. We provide an approach to navigating these management options.
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Internal medicine journal · Oct 2019
Review Practice GuidelineDiagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases.
Candida auris is an emerging drug-resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). ⋯ Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination.
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Internal medicine journal · Oct 2019
Multicenter StudySafety and outcomes of 177 Lu-DOTATATE for neuroendocrine tumours: experience in New South Wales, Australia.
Peptide receptor radionuclide therapy with 177 Lu-DOTATATE is a promising treatment for inoperable or metastatic neuroendocrine tumours (NET). In 2015, the NSW Ministry of Health provided funding for 177 Lu-DOTATATE treatment of NET under an evaluation framework. ⋯ 177 Lu-DOTATATE is a promising treatment for advanced NET. Superior survival in patients who met selection criteria emphasise the importance of protocol adherence.
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Internal medicine journal · Oct 2019
Elevated D-dimer levels predict adverse outcomes in hospitalised elderly patients with chronic heart failure.
Elevated D-dimer levels have been associated with poor outcomes in patients with cardiovascular disease. ⋯ In elderly patients with CHF, measurement of D-dimer levels may help to risk stratify these patients, and high D-dimer levels might be regarded as a warning sign to intensify therapy.
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Internal medicine journal · Oct 2019
Results of a survey of cancer patients' willingness to travel to participate in a clinical trial.
Only 2-3% of cancer patients enrol in a trial. We surveyed patients' willingness to change clinician or treating centre, or to travel, to participate in trials, to improve trial recruitment. ⋯ Rural and regional patients, and those from lower socio-economic areas, were more willing to travel. To optimise access to trials, clinicians should refer within and between institutions.