Internal medicine journal
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Internal medicine journal · Apr 2023
Survey of treatment practices for immunocompromised patients with COVID-19 in Australasia.
Coronavirus disease 2019 (COVID-19) in immunocompromised patients can lead to severe and prolonged illness. Data are limited with regard to management of COVID-19 in this setting, particularly in persistent or recrudescent infection. The authors conducted an online survey among infectious diseases doctors to determine current approaches to treatment across Australasia. There was marked variability in responses relating to the diagnostic modalities and use of antiviral agents in patients with immunocompromise, highlighting the need for high-quality studies to guide treatment decisions in this group.
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Several surgical and percutaneous treatments are available for patients with aortic valve disease. ⋯ Rates of AVR have increased significantly over the past 16 years, particularly in the elderly. Despite international guideline recommendations, fewer mechanical AVR are being used in younger cohorts. The uptake in TAVI rates might reflect evidence that suggests it is a safe alternative, at least in the medium term. BAV has also seen a resurgence during this time period.
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Internal medicine journal · Apr 2023
The basis and implications of diverging approaches to colorectal adenoma surveillance in the West.
Algorithms for the surveillance of colorectal adenomas have recently undergone revision in Australia and abroad. Despite a shared evidence base, significant differences are observed and optimal intervals for surveillance remain controversial. We sought to explore their differences in relation to current evidence, practical aspects and how we may improve our own approach to adenoma surveillance in Australia.
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Internal medicine journal · Apr 2023
Prevalence and correlates of advance care planning among Australian hospital inpatients.
The prevalence and factors associated with advance care planning (ACP) documents for Australian public hospital inpatients were determined through cross-sectional study of 123 Victorian hospitals between July 2016 and December 2018. Of the 611 786 included patients, 2.9% had an ACP document. Odds increased significantly in those comorbid, unpartnered, regional and >5 admissions, which supports future ACP conversations and document creation.
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Internal medicine journal · Apr 2023
Low-dose thioguanine guided by therapeutic drug monitoring is a safe and effective alternative in inflammatory bowel disease patients intolerant to conventional thiopurines.
Thioguanine is an alternative thiopurine for inflammatory bowel disease (IBD) patients. ⋯ Thioguanine was tolerated well in 63% of patients. A clinical response was seen in 62% of patients, and maintenance of remission was high at 76%. No cases of early NRH were seen. Longer-term follow up is required to ensure safety and to assess durability of response.