Internal medicine journal
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Internal medicine journal · Jun 2021
Presenting symptoms of COVID-19 and clinical outcomes in hospitalised older adults.
In July 2020, a COVID-19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care. ⋯ COVID-19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course.
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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
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
Retrospective single-centre analysis of diagnostic approach to adult-onset haemophagocytic lymphohistiocytosis.
Haemophagocytic lymphohistiocytosis (HLH) is a rare disorder with a poor prognosis characterised by substantial immune activation leading to end-organ failure. In childhood, genetic defects that impair cytotoxic function of natural killer cells and T cells. (HLH) are often identified. In adults, clinical manifestations are similar to those observed in children but the aetiology is often unclear. ⋯ The present study highlights the importance of comprehensive application of diagnostic criteria to improve accuracy and timelines of the diagnosis of adult onset HLH.
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Internal medicine journal · Jun 2021
Australian public hospital inpatient satisfaction related to early patient involvement and shared decision-making in discharge planning.
Surveys of hospital inpatient satisfaction may help develop actionable plans for quality improvement, and patients have preferred to give feedback during admission at the point of service compared to after discharge. However, patient satisfaction measurement has often been done by questionnaires post-discharge, and without focussing on an Australian general internal medicine setting. ⋯ In an Australian general internal medicine service, early involvement and shared decision-making in discharge planning are valued by patients. Incorporating checking of patients' understanding of diagnoses, management, discharge instructions, and follow-up plans into ward round routines may benefit patient satisfaction. This study stimulates further research into the use of a proforma to capture and check patients' understanding of discharge diagnoses and plans.