Internal medicine journal
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Internal medicine journal · Jan 2023
Prediction accuracy of commonly used pneumonia severity scores in Aboriginal patients with severe community-acquired pneumonia - a retrospective study.
Severe community-acquired pneumonia (SCAP) is highly prevalent in the Aboriginal population. Few pneumonia severity scores are validated in this population. ⋯ None of the pneumonia severity scores accurately predicted mortality. We recommend SMARTACOP to predict IRVS requirement in Aboriginal patients with SCAP. Given Aboriginal patients are over-represented in Australian intensive care units, a new score is warranted for this understudied population.
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Internal medicine journal · Jan 2023
Glycaemic outcomes in Australasian children and adults with type 1 diabetes: failure to meet targets across the age spectrum.
The goal of therapy in type 1 diabetes (T1D) is to achieve optimal glycaemic targets and reduce complications. Robust data representing glycaemic outcomes across the lifespan are lacking in Australasia. ⋯ Only a minority of children and adults achieve the recommended glycaemic goals despite access to specialist care in major diabetes centres. There is a need to identify factors that improve glycaemic outcomes.
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Internal medicine journal · Jan 2023
Integration of mental health and quality of life screening tools in an inflammatory bowel disease-specific electronic medical record (Crohn Colitis Care): process and early outcomes.
Psychological problems are prevalent in people with inflammatory bowel diseases but are not routinely addressed. To improve recognition, three psychological screening tools were integrated into clinical management software (Crohn Colitis Care). In the first 6 months, completion rates varied between participating sites, and approximately 23-34% of respondents scored in moderate or higher ranges for psychological distress. Evaluation of the clinical utility of the module to improve patient outcomes is recommended.
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Internal medicine journal · Jan 2023
ReviewMethamphetamine-associated cardiomyopathy: an addiction medicine perspective.
Methamphetamine-associated cardiomyopathy (MaCM) is an increasingly recognised serious complication from methamphetamine (MA) use. It is characterised as the development of otherwise unexplained heart failure in the context of MA use. MaCM predominantly affects a young and vulnerable population with high morbidity and mortality. ⋯ Abstinence is difficult for most patients to achieve; all clinicians require an understanding of MaCM and how to educate patients on the risks of ongoing use. Where available, referral to addiction medicine specialists to assist with treatment of MUD is recommended. This review aims to: (i) explain the proposed pathologic mechanisms of MaCM; (ii) summarise recent recommendations of the screening and treatment of MaCM; and (iii) highlight the role of addiction medicine in the management of patient with MaCM.
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Internal medicine journal · Jan 2023
Comment Observational StudyPharmacists reducing medication risk in medical outpatient clinics: a retrospective study of 18 clinics.
The role of pharmacists in hospital inpatient settings is well recognised; however, pharmacists are relatively new to outpatient clinic settings in Australia. Evidence to justify the clinical effectiveness of pharmacists, in terms of identifying and resolving medication-related problems in an outpatient setting in Australia is limited. ⋯ Clinic pharmacists in multidisciplinary outpatient clinics are effective at identifying and resolving medication-related problems. Our research demonstrated that 18% of these resolved recommendations prevented a high-risk medication-related harm event.