Internal medicine journal
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Internal medicine journal · Apr 2022
Predictors of Bleeding in Patients Receiving Direct Oral Anticoagulants.
The predictors of clinically significant bleeding events (CSBE) associated with direct oral anticoagulants (DOAC) are poorly characterised in the literature. ⋯ Caution should be exercised when prescribing antiplatelet medications with DOAC as this combination is a potential risk factor for both major and non-major clinically significant bleeding events. In most patients, the concurrent use of antiplatelet medications was discordant with the current consensus guidelines.
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Internal medicine journal · Apr 2022
Differences in retinopathy prevalence and progression between Anglo-Celt and Aboriginal Australians: The Fremantle Diabetes Study Phase II.
Indigenous populations have higher rates of diabetes and diabetic complications, yet there is a paucity of contemporary data on diabetic retinopathy (DR) prevalence and incidence in urban dwelling Aboriginal Australians. ⋯ Aboriginal participants had a higher prevalence of DR and new or worsening DR, reflecting conventional risk factors including suboptimal glycaemic control. Their significantly higher odds of moderate NPDR or worse in adjusted models suggest ethnic-specific determinants of DR severity. These findings highlight the need for equitable, culturally appropriate diabetes/ophthalmic care.
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Internal medicine journal · Apr 2022
Diabetes in ischaemic stroke in a regional Australian hospital - uncharted territory.
Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population. ⋯ Almost one-third of IS/TIA patients had DM, with a significant proportion showing poor glycaemic control. The DM prevalence in our cohort was comparable with reported rates from other developed countries. Although we found no association between DM and a particular stroke type or mechanism, it is likely a reflection of our cohort size. Our study demonstrated that DM, as a significant risk factor in IS, warrants early detection and better management strategies.
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Internal medicine journal · Apr 2022
Assessment of Liver Fibrosis Markers in People with Rheumatoid Arthritis on Methotrexate.
Up to 3% of methotrexate (MTX)-treated rheumatoid arthritis (RA) patients might develop liver fibrosis or cirrhosis, requiring effective screening algorithms. ⋯ Liver fibrosis develops in a minority of MTX-treated RA patients. The present study suggests that TE is a more sensitive screening test than APRI, FIB-4 or Hepascore in the identification of people with RA at risk of hepatic fibrosis.
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Internal medicine journal · Apr 2022
Risk factors and early prediction of clinical deterioration and mortality in adult COVID-19 inpatients: an Australian tertiary hospital experience.
Early recognition of severe COVID-19 is essential for timely patient triage. ⋯ In the present study, high neutrophil-to-lymphocyte ratio, abnormal d-dimer, high serum CRP and ferritin appear to be useful prognostic markers.