Internal medicine journal
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Internal medicine journal · Mar 2022
Characteristics and outcomes of Aboriginal and Torres Strait Islander patients with dialysis-dependent kidney disease in Australian Intensive Care Units.
In Australia, 531 people per million population have dialysis-dependent chronic kidney disease (CKD5D). The incidence is four times higher for Aboriginal and Torres Strait Islander (indigenous) people compared with non-Indigenous Australians. CKD5D increases the risk of hospitalisation, admission to the intensive care unit (ICU) and mortality compared with patients without CKD5D. There is limited literature describing short-term outcomes of patients with CKD5D who are admitted to the ICU, comparing indigenous and non-indigenous patients. ⋯ Socioeconomic disadvantage contributes to earlier development of CKD5D and the overrepresentation in ICU of indigenous people. Mortality is equivalent once correcting for confounders, but addressing inequality requires strengthening preventative care.
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Internal medicine journal · Mar 2022
Chronic inflammatory back pain commencing late in life: a neglected concept.
Chronic inflammatory back pain (CIBP) occurs in up to one-third of those with chronic back pain. Criteria for diagnosis of inflammatory back pain include an onset below 50 years. ⋯ There is little information in the literature on CIBP of late onset. Patients with late onset CIBP may be falling through the cracks.
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Internal medicine journal · Mar 2022
Specialist haematology consultation services in regional Western Australia: Evaluating a model combining telehealth and onsite clinics.
Models of care that increase specialist medical services to regional or remote patients are being explored worldwide. Many of the models include telehealth (also called telemedicine or video-conferencing consultations) alone or in combination with traditional face-to-face clinic visits. ⋯ The present study demonstrated that the model was effective in providing outpatient services and cost effective to the health service, while being experienced as a satisfactory model by patients.
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Internal medicine journal · Mar 2022
ReviewA Practical Approach to Vertigo: A Synthesis of the Emerging Evidence.
Vestibular presentations are common in both the acute and recurrent setting, burdening emergency departments and community clinics alike. Commonly, an unease among the emergency or general physician is felt, and historically focus has been on gaining knowledge of each potential disease rather than honing the diagnostic process. ⋯ Its simplicity is aimed to minimise uncertainty and highlight clear scenarios when to refer. Together with descriptions of the clinically relevant pathophysiology, the reader should approach the vertiginous patient with a new clarity.
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Internal medicine journal · Mar 2022
Review Case ReportsRapidly progressive crescentic diabetic nephropathy: two case reports.
Crescents are not a well recognised feature of diabetic nephropathy. We present two cases of patients presenting with a rapid decline in renal function and subacute onset of nephrotic syndrome. Glomerulonephritis screening was negative, and renal biopsy revealed non-necrotising cellular crescents and typical features of late-stage diabetic nephropathy. We review the literature for diabetic nephropathy with crescents and explore possible underlying mechanisms.