Internal medicine journal
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Internal medicine journal · Jun 2021
ReviewThe Australian burden of invasive group A streptococcal disease - a narrative review.
The Australian and New Zealand governments have allocated significant funding to advance efforts towards a group A Streptococcus (Strep A) vaccine. The argument for Strep A vaccine development has to date focussed on prevention of non-invasive disease (e.g. pharyngitis) and immune-mediated complications (especially rheumatic heart disease). Because of the poorer prognosis and theoretically more precisely known burden of invasive, compared to non-invasive disease, exploration of the burden of invasive Strep A disease could lend further support to the vaccine business case. ⋯ Preventing invasive Strep A disease is an important use for a Strep A vaccine. This narrative review highlights deficiencies in our current understanding of the Australian disease burden. These difficulties would be overcome by nationally consistent mandatory case reporting.
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Internal medicine journal · Jun 2021
Outcomes of Diabetic Ketoacidosis in a Tertiary Center with Restricted ICU Bed Capacity.
Diabetic ketoacidosis (DKA) is an acute metabolic condition, sometimes requiring admission to an intensive care unit (ICU). ⋯ In a setting of limited ICU capacity, DKA treatment does not necessarily require admission to the ICU. When the rising rates of diabetes mellitus and the associated elevated rates of DKA are taken into account, our results highlight the importance of including step-down units when devising local protocols for care of these patients.
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Internal medicine journal · Jun 2021
Erzhu Qinggan Jiedu Recipe improves the clinical outcome of hepatocellular Cancer after surgical resection: a case-control retrospective study.
This study retrospectively reviewed the recurrence rate and survival time of primary hepatocellular carcinoma (HCC) patients after treatment with Erzhu Qinggan Jiedu Recipe (ESQJR), explored the impact of Chinese medicine in reducing tumour recurrence and prolonging survival time, and explored an effective prevention treatment for the recurrence of HCC. ⋯ ESQJR effectively improved long-term survival in resected HCC patients. ESQJR has the potential to be used as an adjuvant therapy with significant beneficial effects for treating HCC.
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Internal medicine journal · Jun 2021
Lung, breast, and bowel cancer treatment for Aboriginal people in New South Wales: a population-based cohort study.
Aboriginal Australians have higher cancer mortality than non-Aboriginal Australians. Lower rates of cancer treatment among Aboriginal people can contribute to this. ⋯ Aboriginal people were significantly less likely to receive surgery for lung cancer than non-Aboriginal people and had fewer attendances with a surgeon, suggesting a need to strengthen referral pathways.
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Internal medicine journal · Jun 2021
Mechanical thrombectomy for emergent large vessel occlusion: an Australian primary stroke centre workflow analysis.
Time to successful reperfusion is a critical prognostic factor for acute ischaemic stroke. Mechanical thrombectomy has become the gold standard treatment for emergent large vessel occlusion stroke. The timely delivery of this highly specialised procedure to patients outside of metropolitan centres presents a dilemma of inequity, with limited workflow data hindering benchmarking and service optimisation. ⋯ Protracted pre-hospital and primary stroke centre workflow times can delay effective treatment for patients with acute ischaemic stroke in regional areas. A systems-level approach to streamlining processes in these key areas is required to bridge this inequity in best practice care.