Internal medicine journal
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Internal medicine journal · Oct 2019
Illicit drug use and acute kidney injury in patients admitted to hospital with rhabdomyolysis.
Severe rhabdomyolysis is associated with acute kidney injury, but it is unclear if patients developing rhabdomyolysis after illicit drug use have a higher risk of acute kidney injury compared to other causes. ⋯ Illicit drug use was associated with acute kidney injury and renal replacement therapy independent of creatine kinase levels.
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Internal medicine journal · Oct 2019
Idarucizumab for dabigatran reversal: the first 6 months in a tertiary centre.
This retrospective audit reviews patients on dabigatran presenting with bleeding or requiring urgent surgery in the Wellington region, whether they received idarucizumab appropriately and the outcome of episodes. Eighty patients were identified with bleeding or need for urgent surgery, 14 of which received idarucizumab. ⋯ Idarucizumab was underutilised with patients who could have benefited not receiving it; however, some patients who were treated may not have required it. Increased awareness and use may improve outcomes.
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Internal medicine journal · Oct 2019
Impact of universal immunohistochemistry on Lynch syndrome diagnosis in an Australian colorectal cancer cohort.
Current guidelines recommend a step-wise screening algorithm for all colorectal carcinomas (CRC) to identify patients with Lynch syndrome (LS). ⋯ Universal IHC testing may increase the detection of LS, and should be implemented where possible. However, the full benefit was limited by low referral to and uptake of genetic testing, and further strategies are needed to overcome these barriers.
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Internal medicine journal · Oct 2019
Cognitive function during exacerbations of chronic obstructive pulmonary disease.
The reported prevalence of cognitive impairment in patients with stable chronic obstructive pulmonary disease (COPD) ranges 36-77%. Few studies report the prevalence of cognitive impairment in acutely unwell COPD patients. ⋯ Cognitive impairment is highly prevalent during hospital admissions with an exacerbation of COPD. This impairment does improve with time, but only a minority recover within a normal range. This will affect patients' abilities to understand and remember information given to them in hospital and adhere to medication regimens.
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Internal medicine journal · Oct 2019
Evaluating a risk assessment tool to improve triaging of patients to colonoscopies.
Colonoscopy is the gold standard in the diagnosis of significant bowel disease (SBD), including colorectal cancer, high-risk adenoma and inflammatory bowel disease. As the demand for colonoscopy services is placing significant pressure on hospital resources, new solutions are needed to manage patients more efficiently and effectively. ⋯ A hybrid model that combines patient-level characteristics with hospital-level resource constraints can demonstrate improved efficiency in a hospital clinic. Further research on risk assessment is required to improve quality patient care and reduce low-value service delivery.