Internal medicine journal
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Internal medicine journal · Nov 2023
Meta AnalysisDiagnostic test accuracy of D-dimer with or without a clinical decision rule in peripartum patients with suspected venous thromboembolism: A systematic review and meta-analysis.
Pregnancy and the peripartum period is a hypercoagulable state increasing the risk of venous thromboembolism (VTE). There may be a role in utilising D-dimer in the peripartum setting. ⋯ This review highlighted that D-dimer use in the peripartum period for detection of VTE had a high sensitivity and high DOR but a poor area under ROC, which may limit its use in clinical practice.
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Internal medicine journal · Nov 2023
Improving the Accuracy of Discharge Medication Documentation in People with Kidney Disease through Pharmacist-led Partnered Prescribing.
Inaccurate medication documentation in prescriptions and discharge summaries produce poorer patient outcomes, are costly to healthcare systems and result in more readmissions to hospital. Errors in medication documentation are common in Australian hospitals. ⋯ PPP improves the accuracy of the documentation of medications in both the discharge prescription and the discharge summary of patients with kidney disease.
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Internal medicine journal · Nov 2023
ReviewPrognostic value of patient reported outcomes in advanced gastro-oesophageal cancer: a systematic review.
To summarise the prognostic value of patient-reported outcomes (PROs) in advanced gastro-oesophageal (GO) cancer. We systematically searched multiple databases using search terms related to advanced GO cancer, PRO and prognosis. Studies examining the relationship between baseline PROs and prognosis were included. ⋯ One multivariable analysis among participants with oesophageal SCC showed physical and social functioning was associated with OS. Among participants with adenocarcinoma, multivariable analyses showed associations between OS and physical functioning/lack of mobility, appetite loss/anorexia (three studies), global QOL, role functioning/lack of self-care, pain (two studies) and social functioning (one study). Physical functioning, role functioning, social functioning, pain, anorexia and global QOL were associated with OS in advanced GO cancer.
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Internal medicine journal · Nov 2023
Multicenter StudyRefractory Helicobacter pylori infection in Australia: updated multicentre antimicrobial resistance.
Helicobacter pylori infection is responsible for considerable morbidity and mortality worldwide and eradication rates are falling globally because of increasing antimicrobial resistance. However, there is a paucity of local data to guide the choice of eradication therapy in Australia. This study aimed to evaluate current Australian rates of H. pylori antibiotic resistance in patients who had failed prior eradication therapy. ⋯ This first multicentre, multistate study of H. pylori resistance in Australian patients exposed to prior therapy demonstrated high rates of antimicrobial resistance, including levofloxacin (>20%). This raises concern about recommending levofloxacin in empirical second-line therapies. Increased monitoring and awareness of current H. pylori resistance rates in Australia are needed to guide local eradication practices.
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Internal medicine journal · Nov 2023
ReviewTransvenous versus subcutaneous implantable cardioverter defibrillators in young cardiac arrest survivors.
Secondary prevention implantable cardioverter defibrillators (ICDs) are indicated in young patients presenting with aborted sudden cardiac death (SCD) because of ventricular arrhythmias. Transvenous-ICDs (TV-ICDs) are effective, established therapies supported by evidence. The significant morbidity associated with transvenous leads led to the development of the newer subcutaneous-ICD (S-ICD). ⋯ S-ICDs are an important development hindered largely by an inability to pace. Young patients stand to gain the most from a S-ICD as the cumulative risk of lead-related complications is high. A clinical framework to aid decision-making is presented.