Internal medicine journal
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Internal medicine journal · Feb 2021
Meta AnalysisImmunosuppression as a risk factor for COVID-19: a meta-analysis.
While immunosuppression poses a theoretical increase in the risk of COVID-19, the nature of this relationship is yet to be ascertained. ⋯ Compared to the general population, immunosuppressed patients were not at significantly increased risk of COVID-19 infection. This finding provides support for current expert consensus statements, which have recommended the continuation of immunosuppressant therapy in the absence of COVID-19.
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Internal medicine journal · Feb 2021
ReviewSevere asthma assessment, management and the organisation of care in Australia and New Zealand: expert forum roundtable meetings.
Severe asthma imposes a significant burden on individuals, families and the healthcare system. Treatment is complex, due to disease heterogeneity, comorbidities and complexity in care pathways. New approaches and treatments improve health outcomes for people with severe asthma. ⋯ We recommend development of education and training activities, clinical resources and standards of care documents, increased stakeholder engagement and public awareness campaigns and improved access to infrastructure and funding. Further, we propose specific future research to inform clinical decision-making and develop novel therapies. A concerted effort is required from all stakeholders (including patients, healthcare professionals and organisations and government) to integrate new evidence-based practices into clinical care and to advance research to resolve questions relevant to improving outcomes for people with severe asthma.
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Internal medicine journal · Feb 2021
Incidence and predictors of idiopathic pulmonary fibrosis complicating Type 2 diabetes: the Fremantle Diabetes Study Phase I.
During 106 865 person-years of follow up, 17 (1.3%) Fremantle Diabetes Study Phase I participants with Type 2 diabetes and 57 (1.1%) matched individuals without diabetes developed idiopathic pulmonary fibrosis (IPF), an incidence rate ratio (95% confidence interval) of 1.40 (0.76-2.44) (P = 0.22). In the diabetes cohort, age at diabetes diagnosis and total serum cholesterol (inversely) predicted incident IPF in competing risk multivariable models. The incidence of IPF was low in community-based cohorts, regardless of Type 2 diabetes status.
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Internal medicine journal · Feb 2021
Effect of the COVID-19 induced phase of massive telehealth uptake on end-user satisfaction.
COVID-19 has resulted in a massive increase in telehealth utilisation. ⋯ During a rapid increase in its utilisation and scope due to the COVID-19 pandemic, telehealth was generally well accepted by patients, parents and clinicians, which was consistent with pre-COVID-19 experiences.
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Internal medicine journal · Feb 2021
Prevalence and characteristics of post-colonoscopy colorectal cancers in a New Zealand regional centre: a 10-year analysis.
Post-colonoscopy colorectal cancers (PCCRC) are cancers that appear following a colonoscopy in which no cancer is diagnosed. The occurrence of PCCRC is thought to be multifactorial, reflecting both endoscopy quality and potential differences in tumour biology between detected colorectal cancers and PCCRC. ⋯ The prevalence of PCCRC in a New Zealand cohort is consistent with other international reports. Most patients with PCCRC are older, female and have early-stage disease. Of interest, a high proportion of patients developed cancer within a colonic segment with existent pathology, suggesting either missed lesions or incomplete polyp resection.