Internal medicine journal
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Internal medicine journal · May 2020
Short- and long-term outcomes of neutropenic cancer patients in intensive care according to requirement for invasive ventilation.
Neutropenic fever is a frequently encountered complication when caring for cancer patients and can lead to intensive care admission, with high mortality rates in those patients who require invasive mechanical ventilation (IMV). Although hospital survival in this population has improved, long-term outcomes of critically ill neutropenic cancer patients have not been well defined. ⋯ Neutropenic cancer patients admitted to ICU have lower short-term mortality than previously reported in cohort studies, however their mortality rises significantly following discharge from ICU. Those patients who require IMV are at significantly increased risk of both short- and long-term mortality.
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Internal medicine journal · May 2020
Pulmonary embolism: clinical presentation and diagnosis in the oldest old.
The incidence of pulmonary embolism (PE) in the oldest old (persons aged ≥85) is increasing, but there are limited data on its clinical features and diagnosis. We performed a retrospective cohort study of 302 consecutive patients with confirmed PE and compared the oldest old to the young (aged <65) and the younger old (aged 65-84). ⋯ Delayed diagnosis was most common in the oldest old and was associated with increasing age, absence of dyspnoea, presence of cardiorespiratory disease and a higher Charlson Comorbidity index. Better age-specific diagnostic pathways are required in this population.
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Internal medicine journal · May 2020
Selling medical education to international students: time for review.
Over 600 international medical students commence training in Australian medical schools each year. Government funding policies are driving medical schools to recruit more international students. The need to lobby for intern positions for domestic graduates and for international students has placed Australia's medical schools in conflicted positions. It is time for a thorough re-examination of all aspects of medical education in Australia.