Internal medicine journal
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Internal medicine journal · Jan 2021
Randomized Controlled TrialResults from a double blinded, randomised, placebo-controlled, feasibility trial of melatonin for the treatment of delirium in older medical inpatients.
Delirium is common in elderly inpatients, causing distress, cognitive decline and death. No known intervention improves the course of delirium; current treatments are symptomatic, and limited by lack of efficacy and adverse effects. There is an urgent need to find an effective treatment for delirium. ⋯ A trial of the hypothesis that 5 mg melatonin nightly for five nights reduces delirium severity in older medical inpatients would require 120 patients, and is feasible.
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Internal medicine journal · Jan 2021
Multicenter StudyCOVID-19 in Australia: Our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase.
On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later. ⋯ This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.
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Internal medicine journal · Jan 2021
Observational StudyCare to the end. A retrospective observational study of Aged Care Facility residents transferred to hospital in the last day of life.
While transfer of aged care facility (ACF) residents to an acute hospital is sometimes necessary, for those at end of life this can cause fragmented care and disruption. ⋯ Appropriate decision-making around hospital transfers and end-of-life care for ACF residents may be influenced by access to professionals able to diagnose dying and access to appropriate symptom management medications. ACP is important, but often requires the aforementioned to be enacted. Further research is needed to better inform how we can identify and meet the end-of-life care needs of this cohort.
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Internal medicine journal · Jan 2021
Community-based management of complex type 2 diabetes: adaptation of an integrated model of care in a general practice setting.
Overburdened hospital clinics can have adverse outcomes. ⋯ This study confirms the value of integrated community-based care of complex type 2 diabetes which could represent a sustainable solution to overburdened hospital diabetes outpatient clinics.