Internal medicine journal
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Since the recognition of BRAF V600E mutations in the majority of cases of hairy cell leukaemia, Erdheim-Chester disease and Langerhans cell histiocytosis, the targeted oral kinase inhibitors dabrafenib and vemurafenib have been adapted for their treatment. Like other targeted agents, these drugs produce high response rates and predictable but unique side effects. Physician familiarity is essential for the effective use of these agents. We review the Australian experience of BRAF/MEK inhibitor therapy in these rare haematological cancers.
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Internal medicine journal · May 2023
CoBRA: COde Blue Retrospective Audit in a Metropolitan Hospital.
Inhospital cardiac arrest (IHCA) is an uncommon but challenging problem. ⋯ IHCA is uncommon and is associated with high mortality. IHCA prevalence was unchanged after the introduction of a dedicated MET service. Factors associated with improved survival to hospital discharge were initial rhythm VT or VF, cardiac monitoring and shorter resuscitation times.
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Internal medicine journal · May 2023
Current practice, education, and recommendations for training of central line insertion for trainees and fellows in adult ICUs across Australia and New Zealand.
Central venous access device (CVAD) is a common procedure in ICU which, although generally safe, can lead to acute and delayed complications. Training and accreditation process for its insertion vary worldwide. ⋯ The study identified wide variability in current practice, training methods and accreditation process for CVAD insertion among intensivists and ICU trainees in ANZ. Policy makers should consider revising the current clinical practice and training policies to new policies for accreditation and ongoing assessment for CVAD insertions across ANZ ICU.
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Internal medicine journal · May 2023
Screening for Primary Aldosteronism in the Diabetic Population: a cohort study.
Primary aldosteronism (PA) is the most common endocrine cause of hypertension. It is associated with higher cardio-metabolic risk than essential hypertension. Hypertension is common in patients with type 2 diabetes who carry increased cardiovascular risk; however, it is unknown how frequently they are tested for PA. ⋯ In a tertiary diabetes outpatient setting, only a minority of patients who fulfilled the Endocrine Society criteria for PA screening were actually screened. Appropriate screening for PA in the diabetic hypertensive population is necessary for the diagnosis and targeted treatment of a highly modifiable cardiovascular risk factor. Further studies are needed to develop feasible strategies to identify patients with PA in this population.
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Internal medicine journal · May 2023
Consultation with patients for whom English is not their native language.
Good communication with the patient is the cornerstone of effective and efficient consultation. The absence of a common language between the patient and physician negatively impacts the consultation outcome. ⋯ While involving an interpreter may help, it has its downsides and may not be ideal in all situations. Here, we discuss the experiences of various medical practitioners from different cultural and linguistic backgrounds (from Middle Eastern and Asian Countries) in managing non-English-speaking patients with a focus on the impacts of linguistic/cultural barriers in delivering optimal healthcare services and possible solutions to them.