Internal medicine journal
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Internal medicine journal · Jan 2022
Varicella Zoster Virus: An under-recognised cause of central nervous system infections?
Varicella zoster virus (VZV) causes infections of the central nervous system (CNS) manifesting as meningitis or encephalitis. It is not commonly tested in CNS infections when compared with enterovirus (EV) and herpes simplex virus 1 (HSV-1) and 2 (HSV-2). Cerebrospinal fluid (CSF) findings of viral CNS infections are thought to be comparable. ⋯ VZV CNS infection cannot be predicted by syndrome. CSF findings are markedly different from EV but like HSV-1 and 2. VZV should be routinely tested with HSV-1 and 2 when viral CNS infection is suspected.
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Internal medicine journal · Jan 2022
Observational StudyA Cohort Study of Sleep Quality in Adult Patients with Acute Pulmonary Exacerbations of Cystic Fibrosis.
The impact of an acute pulmonary exacerbation of cystic fibrosis (CF) on sleep quality has not been established. Patients have greater burden of symptoms, higher intensity of therapy and are often admitted to hospital outside of their usual sleeping environment. ⋯ Poor sleep quality is common among patients admitted with an acute exacerbation of CF and is strongly associated with insomnia symptoms in this cohort.
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Internal medicine journal · Jan 2022
Cough syncope as a cause of motor vehicle crash: fatal distraction?
Coughing is a rare cause of syncope that can contribute to motor vehicle crashes. The precise pathophysiological mechanisms responsible for the syncope are unclear. ⋯ Cough as a cause of syncope should be a diagnosis of exclusion and used with great caution as a medico-legal defence. A suggested criterion for confirmation of cough syncope is recommended.
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Internal medicine journal · Jan 2022
Pfizer/BioNtech BNT162b2: adverse events and insights from an Australian mass vaccination clinic for COVID-19.
The Pfizer/BioNtech BNT162b2 is a major vaccine used in the Australian COVID-19 immunisation programme. We report on BNT162b2 safety in the observation period in a dedicated vaccination clinic linked to a quaternary teaching hospital. We performed a retrospective review of medical records for 57 842 vaccinations, and describe the model of care and adverse event rate at the clinic during its first 2 months of operation. ⋯ A female predominance was present in both total adverse reactions (70%) and allergic vaccine reactions (79%). Only two patients experienced anaphylaxis (0.003% of total doses), in keeping with low rates of adverse reactions to the BNT162b2 vaccine in the current literature. Overall, the present study reinforces the safety of BNT162b2 in the Australian population, describes vaccination completion rates after adverse events and identifies predisposing factors for rare allergic reactions to the vaccine.
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Internal medicine journal · Jan 2022
Back to the future: lethal respiratory pandemics in New Guinea.
Lethal respiratory epidemics have torn through Papua New Guinea (PNG) since records began in the 19th century. Such historical epidemics were likely caused by influenza but often exacerbated by secondary bacterial pneumonias. ⋯ This pre-independence crisis was met by a major deployment of the Australian Defence Force personnel and aircraft. Currently, vaccination efforts aided by the Australian Government are trying to cope with the COVID-19 crisis.