Internal medicine journal
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Internal medicine journal · Jun 2022
Regional variation in cardiac implantable electronic device implants trends in New Zealand over the past decade (ANZACS-QI 54).
Permanent pacemaker (PPM) and implantable cardioverter defibrillator (ICD) implant rates have increased in New Zealand over the past decade. ⋯ There was significant variation in PPM and ICD implant rates across regions and DHB, suggesting potential inequity in patient access across New Zealand.
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Internal medicine journal · Jun 2022
Psychological flexibility is associated with less diabetes distress and lower glycated haemoglobin in adults with type 1 diabetes.
Diabetes distress, self-efficacy and health literacy are associated with diabetes self-management and health outcomes. Measures of coping styles and their impact on diabetes self-management and diabetes-related distress might add value in identifying those at risk of poorer health outcomes. Current evidence of associations between psychological flexibility/inflexibility and diabetes-related health outcomes is limited. ⋯ Greater psychological flexibility was associated with less diabetes distress and lower HbA1c. The psychological flexibility construct might inform alternative interventional approaches aiming to improve well-being and glycaemic control.
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Internal medicine journal · Jun 2022
ReviewPlatypnoea-Orthodeoxia Syndrome as an Uncommon Cause of Dyspnoea: a Literature Review.
Platypnoea-orthodeoxia syndrome (POS) is an uncommon but challenging clinical condition characterised by positional dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position that improve in the supine position. Since its first description, many cases have been reported and many conditions have been associated with this syndrome. Herein, we review the clinical presentation, pathophysiology, diagnostic work-up and management of patients with POS, aiming to increase the awareness of this often misdiagnosed condition.
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Internal medicine journal · Jun 2022
High Frequency of Anticoagulation Management Errors Preceding Ischemic Strokes in Atrial Fibrillation.
Anticoagulants are recommended to prevent cardioembolic stroke in most patients with atrial fibrillation (AF). Management errors with anticoagulation and use of aspirin instead of anticoagulants have been documented worldwide, especially with vitamin K antagonists. ⋯ Inappropriate management of anticoagulants is present in the majority of acute ischaemic stroke in the 2 weeks preceding the event and is linked to higher mortality. Improved anticoagulation practice has the potential to substantially reduce stroke rates in patients with AF.
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Internal medicine journal · Jun 2022
Effectiveness of a locality-based integrated diabetes care service on clinical outcomes.
Diabetes management often requires close cooperation between primary and specialist services, but a range of challenges in Australia and elsewhere make seamless care difficult. ⋯ Glycaemia and cardiovascular risk factors can be reduced in patients with long-standing Type 2 diabetes by moving to a locality-based integrated primary-secondary care diabetes care service.