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
COVID-19 Pandemic: End of Life Experience in Australian Residential Aged Care Facilities.
The COVID-19 pandemic has significantly impacted those in residential aged care facilities (RACF). This research was undertaken to explore and better understand the effects of the pandemic on the experience of next-of-kin and carers who encountered the death of a loved one who resided within a RACF during the pandemic. ⋯ Findings identify the many COVID-19 pandemic-related challenges faced by participants and their dying loved one in RACF. Access to palliative care and bereavement support is crucial for dying residents and for grieving that has been made more difficult by the pandemic.
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Internal medicine journal · Mar 2022
Obstructive sleep apnoea and adherence to continuous positive airway therapy among Australian women.
Clinical characteristics of women with different obstructive sleep apnoea (OSA) severity and adherence to continuous positive airway pressure (CPAP) therapy have not been previously explored. ⋯ Older age, higher BMI and the presence of hypertension predicted the presence of OSA. The REM sleep-related AHI was higher. Adherence to CPAP was associated with symptomatic OSA and severe oxygen desaturation.
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Internal medicine journal · Mar 2022
No association of Gaucher Disease with COVID-19-related outcomes: a nationwide cohort study.
It is well documented that patients with chronic metabolic diseases, such as diabetes and obesity, are adversely affected by the COVID-19 pandemic. However, when the subject is rare metabolic diseases, there are not enough data in the literature. ⋯ According to our national data, SARS-CoV-2 infection in patients with GD does not have a more severe course than the normal population.
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Internal medicine journal · Mar 2022
Real-world experience with limited screening for occult malignancy in patients presenting with spontaneous venous thromboembolism: a single-centre, retrospective cohort study.
Spontaneous venous thromboembolism (VTE) may represent the first manifestation of previously undiagnosed malignancy; however, contemporary international guidelines call for a limited approach to screening for malignancy in such patients. This retrospective cohort study of 328 patients presenting to the Auckland City Hospital Thrombosis Unit identified 17 patients who were subsequently diagnosed with some form of malignancy within 12 months of their presentation. Review of their history, physical examination and limited age and gender-appropriate cancer screening investigations as described by the National Institute for Clinical Excellence and International Society of Thrombosis and Haemostasis guidelines revealed that all 17 would have been safely diagnosed by the 'limited' screening approach endorsed by these guidelines, thus presenting a 'real-world' basis for clinicians to pursue 'limited' screening for malignancy in their everyday practice in patients with spontaneous VTE.