Internal medicine journal
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Internal medicine journal · Mar 2020
James Cook's first Pacific voyage: alleged scurvy-freedom unmasked.
The east coast of New Holland was discovered 250 years ago during a voyage of covert strategic exploration of the Pacific Ocean regions by Lieutenant James Cook acting under instructions of the Royal Navy espionage chief, Philip Stephens, Secretary of the Admiralty. In addition to the study of the transit of Venus, the well resourced mission included some clandestine mapmaking during August 1768 to July 1771. Tasked by the Royal Society of London to investigate the anti-scorbutic effects of a variety of foods and herbs, Cook's post-operational debrief to the Admiralty included the inaccurate supposition that HM Bark Endeavour's cruise was scurvy-free. Why did Cook extend deceptive cartographic practices deliberately to conceal the apparent failure of the anti-scorbutic comestibles?
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Internal medicine journal · Mar 2020
Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence-practice gap?
In Australia, one-third of human immunodeficiency virus (HIV) diagnoses occur late, with an estimated 11% of people with HIV unaware of their diagnosis. Undiagnosed and untreated HIV infection increases morbidity in the HIV positive person and allows onward transmission of HIV. ⋯ Although HIV testing rates for IC doubled following the intervention, they remained unacceptably low. The recently introduced electronic medical record presents opportunities to prompt HIV testing.
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Internal medicine journal · Mar 2020
Under-detection of acute kidney injury in hospitalised patients: a retrospective, multi-site, longitudinal study.
Acute kidney injury (AKI) is a rapid deterioration of renal function, often caused by a variety of co-existing morbidities complicating its recognition and treatment, leading to short- and long-term adverse clinical outcomes. There are limited data on the incidence of AKI in Australia using the Kidney Disease Improving Global Outcomes creatinine-based consensus definition. ⋯ Although coding trends suggested a continuous increase in clinician awareness of AKI across the study period, AKI in hospitalised patients remained significantly under-reported.
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Internal medicine journal · Mar 2020
Pre- and post-bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender.
Donor safety is paramount when performing bone marrow stem cell harvest. The incidence of full blood count (FBC) abnormalities among donors and variables associated with anaemia after marrow harvest are not well established. ⋯ Pre-harvest anaemia should be corrected where possible particularly in female donors. Marrow collection volume should be minimised to reduce post-harvest anaemia, optimise CD34+ cell number and improve nucleated and stem cell concentrations in the harvest product.