Internal medicine journal
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Internal medicine journal · Dec 2020
Observational StudyClinical profile, anatomical features and long-term outcome of acute coronary syndromes in human immunodeficiency virus-infected patients.
Long-term prognosis of acute coronary syndromes (ACS) in human immunodeficiency virus (HIV)-infected patients is unknown. ⋯ HIV patients with ACS had more frequent multivessel disease and heart failure than matched controls. However, in-hospital and long-term mortality was similar in both groups. Non-cardiovascular re-hospitalisations were more common in HIV patients.
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Internal medicine journal · Dec 2020
Trends in practice: attitudes and challenges in the diagnosis, treatment and management of HIV infection in Australia.
As life expectancy for people living with human immunodeficiency virus (HIV) (PLWHIV) increases, management models for HIV infection are changing. To understand approaches to practice within this shifting climate and across different medical settings, in 2017 we conducted a baseline survey among the main medical practitioner groups responsible for HIV-infection care in Australia: hospital-based physicians (HBP), sexual health physicians (SHP) and 'accredited general practitioners' (referred to in 2017 study as 's100 GPs'), who are GPs authorised to prescribe HIV therapies after completing accredited national training. The follow-up survey presented here explores any changes in approaches, attitudes and challenges associated with HIV-infection management among the same practitioner groups: 17 HBP, 15 SHP and 69 accredited GP (referred to throughout as GP; includes those with sexual health diploma). ⋯ Addressing mental health issues for PLWHIV was again highlighted as a major priority, with practitioners overwhelmingly reporting mental health management as among their most difficult clinical challenges. Reduction in stigma/discrimination and better access to substance dependency programmes were also identified as unmet needs for this patient cohort. Consistent with our baseline survey, it appears targeted interventions and supports appropriate to this population are still required to improve overall wellbeing for PLWHIV.
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Internal medicine journal · Dec 2020
Point-of-care testing of HbA1c, renal function and lipids in remote or disadvantaged regions.
For optimal diabetes management HbA1c, lipid and renal function measurements are key. Suitable point-of-care systems can provide such data in remote areas, diabetes camps, disaster relief, small community hospitals and in community screening days in disadvantaged regions. Some systems are currently used in Australian rural, remote and indigenous health services.
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Internal medicine journal · Dec 2020
Challenges in diagnosing hydroxychloroquine myopathy during the COVID-19 pandemic.
Hydroxychloroquine is being used for COVID-19 symptoms and in clinical trials, but can cause a toxic myopathy that leads to muscle weakness. A review of skeletal muscle biopsies from patients with hydroxychloroquine myopathy gives pointers of steps that can be taken to diagnose this toxic myopathy early and help differentiate it from COVID-19-related muscle weakness.
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Internal medicine journal · Dec 2020
Pandemics in ancient Greek and Roman coinage: medical memories at the service of hope.
Medical goddesses and gods invoked in the Hippocratic Oath were called on in times of pandemics along with Greek physicians such as Galen of Pergamum. Ancient Greek and Roman coinage provide insights into the coexisting religious and rational approaches to medicine rooted in Classical Antiquity, portraying medical symbols and gestures akin to contemporary medicine.