Internal medicine journal
-
Internal medicine journal · Dec 2021
Utilization of telehealth for outpatient diabetes management during COVID-19 pandemic: how did the patients fare?
During the Coronavirus disease 2019 (COVID-19) pandemic, many outpatient services at public hospitals, including diabetes services, had adopted telehealth appointments for their clinic patients. There was concern that patients' glycaemic control may worsen during the pandemic. ⋯ The present study showed that for patients with diabetes who received care via telehealth consultations during the COVID-19 lockdown, their glycaemic control was slightly better, and unplanned admission rates were not higher compared with those in the pre-COVID-19 period. Telehealth consultation offers an important care delivery option in the management of patients with diabetes under these circumstances.
-
Internal medicine journal · Dec 2021
Discussion of Advance Care Planning on end of life decisions with lung cancer patients in Wuhan China: Attitude, Timing, and Future Directions.
Progress in advance care planning (ACP) in China has been hindered for decades compared with other countries. ⋯ Chinese patients showed preferences towards ACP, but with inadequate knowledge. More assistance is needed with ACP for those patients, especially for females, patients with one child and those with early stage lung cancer. For female patients and patients receiving treatment, doctors may initiate ACP dialogue first.
-
Internal medicine journal · Dec 2021
Invasive pulmonary aspergillosis in critically ill patients with COVID-19 in Australia: implications for screening and treatment.
We report four cases of invasive pulmonary aspergillus co-infection in patients with coronavirus disease 2019 (COVID-19) infection and acute respiratory distress syndrome requiring intensive care unit (ICU) admission. Aspergillus fumigatus and Aspergillus terreus were isolated, with early infection onset following ICU admission. ⋯ We propose screening of these high-risk patients with twice-weekly fungal culture from tracheal aspirate and, if feasible, Aspergillus polymerase chain reaction. Diagnosis is challenging and antifungal treatment should be considered in critically ill patients who have new or worsening pulmonary changes on chest imaging and mycological evidence of infection.
-
Internal medicine journal · Dec 2021
Developments in systemic therapies for the management of lung cancer.
Lung cancer accounts for approximately 1 in 10 new cancer diagnoses annually and is responsible for the most cancer-associated deaths in Australia. Despite such figures, there is reason for optimism with many practice-changing developments to report for the management of patients with thoracic malignancies over the last few years. We outline such changes, including the emerging role of immunotherapy in the neoadjuvant and adjuvant setting for patients with localised non-small-cell lung cancer, as well as the established standard of consolidation immunotherapy following definitive chemoradiotherapy for those with locally advanced disease. ⋯ Even among patients with small-cell lung cancer, who account for the worst prognoses and until recently have received a chemotherapy regimen that has remained unchanged in over 20 years, there is a new standard-of-care in combination chemotherapy-immunotherapy. Furthermore, immunotherapy and potentially anti-vascular endothelial growth factor agents now also play a role in mesothelioma treatment. Last, given recent developments in immunotherapy, targeted therapy and combination approaches in the non-small-cell lung cancer space, there is an increasing recognition of the diversity of lived experience for such patients and need for survivorship programmes to acknowledge such nuances.