Internal medicine journal
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Internal medicine journal · Nov 2020
Trends in stroke reperfusion treatment and outcomes in New Zealand.
Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) can help reverse stroke symptoms in selected patients but are both time sensitive interventions. ⋯ Stroke reperfusion rates in New Zealand are continuously rising with no associated increase in complications. More patients are being treated faster upon hospital arrival but there remains room for further improvement in reducing onset to treatment delays.
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Internal medicine journal · Nov 2020
Prevalence of hyperglycaemia without previously recognised diabetes mellitus in the emergency department and subsequent management: a retrospective cross-sectional study.
Australian hospital data on hyperglycaemia without previously known diabetes are lacking. ⋯ Hyperglycaemia without previously recognised diabetes is commonly seen and justifies ED screening. However, management of newly detected hyperglycaemia in these patients is suboptimal and requires improvement.
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Internal medicine journal · Nov 2020
Poor initiation of smoking cessation therapies in hospitalised patients with chronic obstructive pulmonary disease is associated with low levels of formal training among hospital doctors and under-utilisation of nursing-led interventions.
Smoking cessation intervention is a key component in the management of chronic obstructive pulmonary disease (COPD). ⋯ Our study highlights the real-life challenges in tackling nicotine dependence in hospitals: under-utilisation of evidence-based pharmacotherapies, limited access to formal training for doctors and poor uptake of nurse-led smoking cessation services. Granting limited prescribing rights for specialised nurses may help hospital clinicians to alleviate gaps in current clinical practice.
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Internal medicine journal · Nov 2020
Preventive use of non-invasive ventilation is associated with reduced risk of extubation failure in patients on mechanical ventilation for more than 7 days: a propensity-matched cohort study.
Extubation failure (EF) is high in patients on mechanical ventilation for more than 7 days. However, strategies to prevent EF in this population are lacking. ⋯ In patients on mechanical ventilation for more than 7 days, preventive use of NIV is associated with a reduction in EF.