Internal medicine journal
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Internal medicine journal · Jan 2023
Comment Observational StudyEffects of a prescribed, supervised exercise program on tumour disease progression in oncology patients undergoing anti-cancer therapy: A retrospective observational cohort study.
Exercise promotes numerous advantages in both health and disease, and is increasingly being acknowledged to improve overall survival in cancer patients. Preclinical studies indicate a direct effect on tumour behaviour, but human data on the effect of exercise on tumour progression are lacking. ⋯ Supervised exercise programmes have the potential to significantly improve outcomes in cancer patients due to an effect on tumour progression.
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Internal medicine journal · Jan 2023
Tinzaparin for venous thromboembolism in patients with renal impairment - a single-centre, prospective pilot study.
Low molecular weight heparins (LMWH) are used extensively for prophylaxis and treatment of venous thromboembolism (VTE), bridging therapy for warfarin and standard of care in cancer-associated VTE (CA-VTE). Tinzaparin has the highest molecular weight of all LMWH and relies least on renal clearance to Cockcroft-Gault creatinine clearance (CrCl) of 20 mL/min. Previous pharmacological studies have demonstrated safety and effectiveness in elderly patients. Prospective clinical trials have confirmed these findings to CrCl 20 mL/min and in CA-VTE. We describe the pilot program developed at Concord Repatriation General Hospital for tinzaparin. ⋯ For patients with renal insufficiency, tinzaparin represents an attractive alternative anticoagulant with once-daily administration in a range of potential indications.
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Internal medicine journal · Jan 2023
Diabetes IN hospital - Glucose and Outcomes in the COVID-19 pandemic (DINGO COVID-19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations.
A relationship between diabetes, glucose and COVID-19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID-19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. ⋯ During the first year of the COVID-19 pandemic, in-hospital hyperglycaemia and known diabetes were not associated with in-hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality-reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID-19 morbidity within both local and global contexts.
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Internal medicine journal · Jan 2023
Symptom persistence and recovery among COVID-19 survivors during a limited outbreak in Canterbury, New Zealand: a prospective cohort study.
In Canterbury, near complete identification of coronavirus disease 2019 (COVID-19) cases during a limited outbreak provides unique insights into sequelae. ⋯ Persistent symptoms and longer recovery times were found in COVID-19 survivors, but not impaired generalised anxiety levels or HrQoL compared with COVID-19-uninfected participants.
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Internal medicine journal · Jan 2023
A clinical scoring approach for detection of histiocytic necrotizing lymphadenitis in adults.
Histiocytic necrotising lymphadenitis (HNL) is rare and can be easily ignored. ⋯ The present study suggests that the novel scoring approach we put forward might be useful to detect HNL in adult patients though further studies are needed.