Internal medicine journal
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Internal medicine journal · Nov 2021
Actual and perceived knowledge of research ethics guidelines in a sample of public health clinicians.
The conduct of research by clinicians is vital to maintain evidence-based practice and currency of clinician knowledge. However, the ability to conduct valid research is contingent on several factors including the knowledge of research ethics guidelines applicable within the researcher's location. ⋯ Clinicians are not as knowledgeable as they think about research ethics. This has implications for help-seeking behaviours within this population and highlights challenges for stakeholders in the provision of research support and education.
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Internal medicine journal · Nov 2021
Screening for Diabetic Retinopathy and Reduced Vision among Indigenous Australians in Top End Primary Care Health Services: a TEAMSnet Sub-study.
Diabetic retinopathy (DR) prevalence is higher in Indigenous Australians than in other Australians and is a major cause of vision loss. Consequently, timely screening and treatment is paramount, and annual eye screening is recommended for Indigenous Australians. ⋯ A high prevalence of DR, CSMO and impaired vision was noted in Indigenous Australians with diabetes. Screening in primary care is feasible, but more effective screening methods are needed.
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Internal medicine journal · Nov 2021
Polypharmacy And The Use Of Low Or Limited Value Medications In Advanced Cancer.
Patients with advanced malignancy are often on medications for co-morbidities, including those for primary or secondary prevention. The benefit from these medications can be limited and may result in adverse effects, interact with medications used for the malignancy or associated symptoms, increase pill burden and reduce quality of life. ⋯ Polypharmacy and continued prescribing of low or limited value medications was identified in a high proportion of patients. Further studies are needed to assess the impact of continuing these medications, as well as investigation of patient and physician attitudes towards de-escalation.
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Internal medicine journal · Nov 2021
Fixed-dose three-factor prothrombin complex concentrates is safe and effective in warfarin reversal.
Reversal of warfarin with prothrombin complex concentrates (PCC) is required in cases of significant bleeding or need for urgent surgery. A weight-based regimen is commonly, but a fixed-dose approach is also feasible with clinically equivalent outcomes. The purpose of this audit is to review the clinical and laboratory outcomes of patients treated in our centre where fixed-dose PCC is used for warfarin reversal. ⋯ Our results support the use of fixed-dose PCC for warfarin reversal in a day-to-day clinical practice in a hospital setting.
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Internal medicine journal · Nov 2021
Serum potassium in chronic kidney disease: prevalence, patient characteristics and clinical outcomes.
Abnormalities in serum potassium are a well known complication of chronic kidney disease (CKD), but little is known about their impact on inpatient outcomes. ⋯ Derangements in potassium frequently occur in CKD inpatients and are independently associated with higher mortality and ICU requirement. Further studies are required to determine whether interventions to maintain normokalaemia improve outcomes in this population.