Internal medicine journal
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Internal medicine journal · Aug 2022
Investigating the effect of an education program on diabetes and lipid lowering medication usage following coronary artery bypass graft surgery.
Guidelines advocate multifactorial cardiovascular risk management in patients with diabetes and atherosclerotic cardiovascular disease. ⋯ The intervention did not improve inpatient glycaemia or increase non-statin lipid-lowering prescriptions in patients with diabetes following CABG surgery but did reduce reliance on specialty input. Initiation of SGLT2 inhibitor therapy near time of hospital discharge was not associated with safety concerns. Alternative interventions or strategies are required to optimise glycaemia and non-statin lipid-lowering therapy prescribing in this setting.
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Internal medicine journal · Aug 2022
Observational StudyThe impact of the first wave of COVID-19 on stroke admissions across three tertiary hospitals in Brisbane.
COVID-19 has caused a global shift in healthcare-seeking behaviour; however, presentation rates with serious conditions, such as stroke in low COVID-19-prevalence cities, has received less attention. ⋯ During the early months of the COVID-19 pandemic there was no significant reduction in stroke presentations, use of acute reperfusion therapies or delays to presentation, despite a reduction in ED presentations for any cause. Our results differ from the global experience, with possible explanations, including differences in public health messaging and healthcare infrastructure.
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Internal medicine journal · Aug 2022
Survey of barriers to adherence to international inflammatory bowel disease guidelines: Does gastroenterologists' confidence translate to high adherence?
Despite the availability of evidence-based inflammatory bowel disease (IBD) guidelines, suboptimal care persists. There is little published research assessing barriers to IBD guideline adherence. ⋯ Although gastroenterologists have high confidence in guidelines, they use them infrequently, primarily due to specifics being difficult to remember and lack of time. Self-reported confidence in an area of IBD management does not always reflect knowledge. An intervention targeting these barriers, for example, computer-based clinical decision support tools, might improve adherence and standardise care.
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Internal medicine journal · Aug 2022
Predictors of real-world utilisation of docetaxel combined with androgen deprivation therapy in metastatic hormone-sensitive prostate cancer.
Docetaxel has emerged as a standard-of-care for metastatic hormone-sensitive prostate cancer (mHSPC). Uptake of docetaxel for mHSPC in Australia has not previously been reported. ⋯ Although docetaxel was not used in the majority of cases, there was a clear increase in docetaxel uptake, especially in younger men following publication of the CHAARTED and STAMPEDE trials. Identifying barriers to real-world implementation of pivotal clinical trial data is critical to improving outcomes in mHSPC.
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Internal medicine journal · Aug 2022
Which Glucose Parameter Best Predicts Poor Outcome after Mechanical Thrombectomy for Acute Large Vessel Occlusion Stroke?
Hyperglycaemia is related to adverse outcomes in patients with acute ischaemic stroke (AIS) treated with mechanical thrombectomy (MT). ⋯ ABG and FBG are independent predictors of poor functional outcome in patients with AIS undergoing MT, and FBG has a higher predictive ability than ABG and HbA1c.