Internal medicine journal
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Internal medicine journal · Jul 2022
Outpatient autologous stem cell transplantation in Royal Hobart Hospital, Tasmania: a single-centre, retrospective review in the Australian setting.
Several international centres have published their experiences with outpatient autologous stem cell transplantation (ASCT) as treatment of haematological malignancies. ⋯ Outpatient autografts may save healthcare resources without compromising patient outcomes.
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Internal medicine journal · Jul 2022
Invasive versus Conservative Management in Patients ≥85 years presenting with Non-ST Elevation Myocardial Infarction.
Guidelines recommend early coronary angiography (CA) in patients with non-ST-elevation myocardial infarction (NSTEMI) irrespective of age. However, elderly patients are less likely to be treated according to these guidelines due to their perceived high risk and medical comorbidities. Whether an invasive strategy is associated with improved survival in patients aged ≥85 years remains uncertain due to their exclusion from randomised trials. ⋯ In patients aged ≥85 years who presented with NSTEMI, invasive management was associated with improved survival without significant differences in bleeding or stroke. A randomised controlled study assessing the efficacy and safety of invasive management in very elderly patients with NSTEMI is warranted.
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Internal medicine journal · Jul 2022
Use of a Victorian statewide surveillance program to evaluate the burden of healthcare-associated Staphylococcus aureus bacteraemia and Clostridioides difficile infection in patients with cancer.
Patients with cancer are at high risk for infection, but the epidemiology of healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB) and Clostridioides difficile infection (HA-CDI) in Australian cancer patients has not previously been reported. ⋯ Our findings demonstrate a higher burden of HA-SAB and HA-CDI in a cancer cohort when compared with state data and highlight the need for cancer-specific targets and benchmarks to meaningfully support quality improvement.
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Internal medicine journal · Jul 2022
Pharmacogenomic testing: perception of clinical utility, enablers and barriers to adoption in Australian hospitals.
Despite healthcare professionals (HCP) endorsing the clinical utility of pharmacogenomics testing, use in clinical practice is limited. ⋯ Pharmacogenomic testing was considered important to guide drug selection and dosing decisions. However, limited knowledge, low confidence and an absence of guidelines impede the use of pharmacogenomic testing. Establishment of local resources including multidisciplinary models-of-care was suggested to facilitate implementation of pharmacogenomics.
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Internal medicine journal · Jul 2022
Prevalence and factors associated with Advance Health Directives in frail older inpatients.
Advance health directives (AHD) can be used to explore and document patient preferences for treatment and are therefore an important aspect of care planning. ⋯ The presence of AHD is associated with sociodemographic factors, as well as higher frailty levels. Prevalence of AHD among inpatients has increased over the past decade but remains modest.