Internal medicine journal
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Internal medicine journal · Apr 2022
Clinical relevance of Shear Wave Elastography compared with Transient Elastography and other markers of liver fibrosis - a cross-sectional study.
Early and accurate non-invasive diagnosis of liver fibrosis is important for reducing the burden of cirrhosis and related complications. ⋯ Across various liver diseases, SWE is at least comparable with TE and other non-invasive tests of liver fibrosis. SWE is accurate for predicting liver-related portal hypertension.
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Internal medicine journal · Apr 2022
ReviewDeveloping a framework for implementing Opioid Stewardship Programs in Australian Hospital Settings.
There is growing interest in strategies to improve patient safety with prescription opioids, collectively known as opioid stewardship (OS). This study aimed to develop a framework to facilitate the implementation of OS in the Australian acute hospital setting. Using a Modified Delphi Technique, a diverse stakeholder panel (including patient representatives and multidisciplinary healthcare professionals) was selected. ⋯ The remaining item not agreed on in the initial round was modified based on comments received and reached 100% agreement on importance at the second round. There was greater than 85% agreement on importance of 24 of 27 items for inclusion in a framework with 8 of 27 reaching a 100% level of agreement. We have developed a framework for OS in the Australian acute hospital settings that may be used to guide health services to prioritise and plan strategies to improve opioid use.
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Internal medicine journal · Apr 2022
ReviewRisk factors, Treatment and Outcomes of Subacute Thyroiditis Secondary to COVID-19: A Systematic Review.
COVID-19 is known to cause an acute respiratory illness, although clinical manifestations outside of the respiratory tract may occur. Early reports have identified SARS-CoV-2 as a cause of subacute thyroiditis (SAT). ⋯ COVID-19-associated SAT may be difficult to identify in a timely manner due to potential absence of classic symptoms, as well as cross-over of common clinical features between COVID-19 and thyrotoxicosis.
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Internal medicine journal · Apr 2022
Patient-initiated follow up as a means of reducing pressures in secondary care.
Outpatient services, largely dedicated to routine follow up, have been under increasing pressure in recent years. The growing and ageing UK population has been a large driver of this pressure, requiring a significant increase in annual outpatient appointments. ⋯ One such model, patient-initiated follow up (PIFU) has shown significant promise, empowering patients while simultaneously reducing appointment numbers and increasing attendance rates. However, for PIFU to be implemented nationwide several key considerations must be made to ensure patients are appropriately engaged, and supported, in directing their own care.
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Internal medicine journal · Apr 2022
To Investigate Outcomes In Endoscopic Management Of Early Oesophageal Adenocarcinoma In Barrett's Oesophagus: Experience At Three Australian Tertiary Centres.
Barrett oesophagus is a known precursor of oesophageal adenocarcinoma (EAC). Early EAC includes T1a (invasion into mucosa) and T1b (invasion into submucosa but not muscularis propria). Endoscopic mucosal resection (EMR) provides accurate histological staging and definitive treatment for early EAC. Post EMR, the remaining Barrett is eradicated with radiofrequency ablation (RFA). However, there is a paucity of long-term Australian data. ⋯ EMR in conjunction with RFA is an effective and safe management for early EAC. EMR provides accurate staging and has low complication rates.