Internal medicine journal
-
Internal medicine journal · Mar 2020
Cancer-associated prothrombotic pathways: leucocytosis, but not thrombocytosis, correlates with venous thromboembolism in women with ovarian cancer.
Risk factors for venous thromboembolism in cancer vary between tumours. Leucocytosis, thrombocytosis, tumour histology and vascular compression may drive thrombosis in ovarian cancer. ⋯ Thrombocytosis >350 × 109 /L was frequent (63.8%), but not predictive of thrombosis. Identification of prothrombotic biomarkers may help personalise preventive treatments.
-
Internal medicine journal · Mar 2020
Accuracy and acceptability of survivorship care plans: results of a pilot study.
Survivorship treatment summaries and care plans are increasingly incorporated into cancer care but there are limited data on their accuracy and acceptability. We have evaluated written care plans developed as part of a once-off, nurse-led survivorship consultations across four medical oncology clinics in South Australia as part of a state-wide pilot. While the accuracy of treatment summaries was high, level of detail in care plans was moderate to low, as was survivors' perception of plans' utility.
-
Internal medicine journal · Mar 2020
Diagnosis and management of pregnancies complicated by haemolysis, elevated liver enzymes and low platelets syndrome in the tertiary setting.
Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome occurs in one to six per 1000 pregnancies; maternal death has been reported in 1-24% of cases. Vague presentation is common; hypertension and proteinuria which characterise pre eclampsia are often absent when HELLP syndrome presents. Physicians are often called on to review gravid patients with unexplained symptoms or abnormal laboratory results, and it is vital that these clinicians are aware of the myriad of ways in which HELLP syndrome may present and evolve. ⋯ Misdiagnosis and delayed recognition of HELLP syndrome are common due to vague and varying presentation. When HELLP syndrome is identified delivery is required to avoid catastrophic maternal and neonatal outcomes. We hope to provide guidance for general and obstetric physicians by providing contemporary evidence of the presentation and clinical course of pregnancies complicated by HELLP syndrome.
-
Internal medicine journal · Mar 2020
Management of patients with gout and achievement of target serum urate levels at a tertiary rheumatology service in Australia.
Gout is common crystal arthritis that is often managed sub-optimally. ⋯ Despite effective therapy the number of patients treated for gout at a large public metropolitan teaching hospital reaching SU target was low. Almost one-quarter of patients in the study discontinued contact with the clinic. The reasons for this are not clear and are likely multifactorial.