Internal medicine journal
-
Internal medicine journal · May 2022
Patient preferences using telehealth during COVID-19 pandemic in four Victorian tertiary hospital services.
The Coronavirus disease 2019 (COVID-19) pandemic has had a major impact on healthcare services with many changes to telehealth care delivery. More information is needed about the patient perspective of telehealth in hospital services and the potential costs and benefits for patients. ⋯ Telehealth video consultations were largely evaluated positively with most patients considering the service to be as good as in-person. Understanding patient preference is critical to consider when implementing telehealth as mainstream across hospital health services.
-
Internal medicine journal · May 2022
ReviewPrescription trends and costs of diabetes medications in Australia between 2003 and 2019: an analysis and review of the literature.
Since the turn of the century, the prevalence of diabetes mellitus in Australia has increased, primarily due to rising rates of Type 2 diabetes. Simultaneously, the landscape of diabetes medications has evolved significantly. The change in prescribing trends and public spending on diabetes medications within Australia during this period are not well defined. ⋯ Our data show a large growth in the use of diabetes medications between 2003 and 2019. The rapid growth in dispensing of drugs with proven cardiovascular and renal benefits reflect the evolving approach of diabetes treatment, from a historical approach targeting glycaemic control alone, to a modern individualised approach targeting specific co-morbidities.
-
Internal medicine journal · May 2022
Corticosteroid exposure prior to admission and predicting need for rescue therapy in acute severe ulcerative colitis.
Steroid exposure has been associated with poorer outcomes following colectomy in acute severe ulcerative colitis (ASUC). ⋯ Prolonged steroid use prior to ASUC admission is a significant predictor of need for rescue therapy. A generalised linear model incorporating steroid prior to admission, endoscopic Mayo score and albumin was highly accurate at predicting failure of corticosteroid. Consideration should be given for commencement of rescue therapy prior to Day 3, especially in those with prolonged steroid prior to admission.
-
Internal medicine journal · May 2022
Case ReportsMusculoskeletal immune-related adverse events with use of checkpoint inhibitors in malignancy.
Immunotherapy has revolutionised the treatment of many malignancies. Along with their success, there have been inflammatory and immune-related adverse events (irAE). There is a paucity of literature describing the Australian experience of rheumatic irAE. ⋯ Rheumatic irAE are heterogenous clinical entities, which require further evaluation into classification, patient susceptibility and response. From our study, there was no clear clinical pattern. The present case series supports that rheumatic irAE may be associated with tumour response. However, there is still limited experience in rheumatic irAE management and outcomes.
-
Internal medicine journal · May 2022
Nitrous Oxide-Induced Neurological Disorders - an increasing public health concern.
Neurological presentations resulting from nitrous oxide (N2 O) abuse are increasing in Australia and worldwide. Despite known neuropsychiatric sequelae, N2 O canisters remain readily available and its use unregulated. ⋯ Recreational N2 O use is an emerging health problem in Australia. International university students and patients with pre-existing mental illness or polydrug use appear to be at increased risk. A severe motor neuropathy may emerge following vitamin B12 replacement. Public health measures are required to limit the availability of N2 O and to educate adolescents and young adults about the potential for significant harm.