Internal medicine journal
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Internal medicine journal · Mar 2023
LetterSociodemographic determinants of telehealth utilisation in general practice during the COVID-19 pandemic in Australia.
This analysis assessed the sociodemographic characteristics of telehealth utilisation during the coronavirus disease 2019 (COVID-19) pandemic from March 2020 to August 2021 in Australia. Drawing on 860 general practice providers among 3 161 868 patients, 24 527 274 consultations were recorded. Telehealth accounted for 37.6% of the consultations, with 2.4% through videoconferencing and 35.2% through phone consultations. Our multivariate regression analyses indicated low utilisation of videoconferencing compared with phone consultations among older adults, those living in rural communities and migrants from non-English speaking countries.
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Internal medicine journal · Mar 2023
Inpatient Cardiac Care for Acute Coronary Syndromes in the Top End of Australia.
Disparities in cardiovascular outcomes between Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians persist. This has previously been attributed to a combination of differences in burden of cardiovascular disease risk factors, and inpatient access to guideline-recommended care. ⋯ Aboriginal and Torres Strait Islander patients received similar inpatient ACS care and secondary prevention medication at discharge, with similar short-term mortality outcomes as non-indigenous patients. While encouraging, these outcomes may not persist long term. Further outcomes research is required, with differences compelling consideration of other primary and secondary prevention contributors.
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Internal medicine journal · Mar 2023
Mortality outcomes for MĀori requiring renal replacement therapy during critical illness: A single unit audit in Aotearoa New Zealand.
Māori in New Zealand (NZ) are disproportionately affected by chronic kidney disease (CKD) and experience lower life expectancy on community dialysis compared with non-Māori. We previously identified a higher renal replacement therapy (RRT) requirement for Māori in our intensive care unit (ICU), the tertiary referral centre for NZ's Te Manawa Taki region. ⋯ Increased RRT requirement among Māori in our ICU is due to higher representation among ESRD. We did not demonstrate excess mortality by ethnicity in any stratum. AKI-RRT had higher in-ICU mortality than ESRD, but this reversed at 1 year.
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Internal medicine journal · Mar 2023
Clinical Characteristics and Outcomes of Critically Ill Patients with 1, 2 and 3 doses of Vaccination against COVID-19 in Australia.
Vaccination has been shown to be highly effective in preventing death and severe disease from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Currently, few studies have directly compared vaccinated and unvaccinated patients with severe COVID-19 in the intensive care unit (ICU). ⋯ We found COVID-19 infection can cause severe disease and death in vaccine recipients, though comorbid status and older age were significant contributors to mortality. Organ support requirements and the number of deaths were highest in the unvaccinated cohort.
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Internal medicine journal · Mar 2023
Diabetes mellitus is an independent predictor of obstructive coronary artery disease in patients presenting with atrial fibrillation and elevated troponin.
Atrial fibrillation can present with symptoms of myocardial infarction and elevated troponin, even in the absence of obstructive coronary artery disease (CAD). We sought to determine the characteristics that predict underlying obstructive CAD. Obstructive CAD was far more likely in those with troponin elevation. In those with elevated troponin, diabetes mellitus was an independent predictor of obstructive CAD.