Internal medicine journal
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Internal medicine journal · Oct 2022
Human immunodeficiency virus and solid organ transplantation: a 15-year retrospective audit at a tertiary Australian transplant centre.
The incidence of end-stage organ disease in people living with human immunodeficiency virus (HIV) (PLWH) is increasing, as people live longer due to potent, tolerable antiretroviral therapy (ART). Consequently, the number of PLWH who would benefit from solid organ transplant (SOT) is rising. The SOT experience in PLWH in Australia remains limited. Aim To retrospectively review the outcomes for SOT in PLWH at our service, in Victoria, Australia. ⋯ PLWH with end-stage organ disease experience good clinical and functional outcomes and should be considered for SOT where indicated. However, multidisciplinary planning and care is essential to optimise care in this patient group.
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Internal medicine journal · Oct 2022
Opioids in advanced lung malignancy: A clinical audit of opioid prescription, patient education and safeguarding.
Opioids have an important role in symptom management for people with advanced cancer. Clinical guidelines recommend patient education to ensure the safe use of opioids; however, no Australian studies have explored current education and safeguarding practices when opioids are initiated to advanced cancer patients. ⋯ Guideline-recommended risk assessment, safeguards and patient education were infrequently documented when opioids were initiated. Clinician training, decision-assist prompts in electronic prescribing software and written education resources for patients may address these gaps in care.
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Internal medicine journal · Oct 2022
Use of telemedicine for rheumatology practice in Queensland, Australia: Experiences before and during the COVID-19 pandemic.
In Australia there is a shortage of rheumatologists potentially translating to poorer outcomes. A possible solution in this setting is telemedicine (TM). ⋯ Familiarity with TM exists in this rheumatologist cohort; however, its use in routine practice is limited due to multiple barriers. The COVID-19 pandemic highlighted low confidence in telephone calls as a form of TM underlining the need for appropriate TM models of care for rheumatology practice.
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Internal medicine journal · Oct 2022
Assessment of subclinical left ventricular systolic dysfunction and structural changes in patients with chronic obstructive pulmonary disease.
Patients with chronic obstructive pulmonary disease (COPD) can develop left ventricular (LV) systolic dysfunction and geometric changes due to several reasons. ⋯ Subclinical LV systolic dysfunction can occur in COPD patients despite normal EF. STE is a technique that provides additional information for detailed evaluation of subtle changes in LV myocardial contractility, significantly associated with the severity of the disease in COPD patients.