Internal medicine journal
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Internal medicine journal · Nov 2024
Review Practice GuidelineAdult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network.
Penicillin allergy is a significant burden on patient, prescribing and hospital outcomes. There has been increasing interest in the incorporation of penicillin allergy testing (i.e. delabelling) into antimicrobial stewardship (AMS) programmes to reduce the burden of penicillin allergy labels and improve prescribing. In particular, there has been a focus on point-of-care penicillin allergy assessment and direct oral challenge for low-risk phenotypes. The National Antibiotic Allergy Network has provided a guide to assist AMS clinicians with the incorporation of penicillin allergy programmes, in particular direct oral challenge, into Australian hospitals.
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Internal medicine journal · Nov 2024
Injecting drug use is a risk factor for methicillin resistance in patients with Staphylococcus aureus bloodstream infections.
We investigated whether injecting drug use was a risk factor for methicillin resistance among inpatients with Staphylococcus aureus bloodstream infections (SABSIs) at an Australian health service. In 273 inpatients, 46 (16.9%) of SABSIs were methicillin-resistant S. aureus (MRSA). MRSA was more frequent in those who had injected drugs in the past 6 months (20.6%) compared with other inpatients (15.7%). Injecting drug use was associated with a 4.82-fold (95% confidence interval = 1.54-16.29) increased odds of MRSA after accounting for confounders.
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Internal medicine journal · Nov 2024
The experience of an adult diabetic foot unit continuing face-to-face consults during the COVID-19 pandemic.
The COVID-19 pandemic significantly disrupted lower limb diabetes care. We aimed to map trends in diabetes-related lower limb amputation and hospitalisation rates through the COVID-19 pandemic. ⋯ Despite increased hospitalisations for diabetes-related foot complications during COVID-19, there was not a corresponding increase in amputation rates. Face-to-face care of diabetes-related foot complications was prioritised at this centre and may have contributed to stable amputation rates during the pandemic.
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Internal medicine journal · Nov 2024
Characteristics of arthritis in patients with familial Mediterranean fever.
Many of the familial Mediterranean fever (FMF) patients present with arthritis during attacks, which may vary in its characteristics. ⋯ Since M694V mutation is common and the colchicine dose required for disease control is high, we can conclude that the disease activity is high in FMF patients with arthritis. The frequency of sacroiliitis and spondyloarthropathy is significantly increased, especially in individuals with M694V mutation, suggesting that there may be a common pathway in their pathogenesis. FMF should be included in the differential diagnosis in patients presenting with arthritis in FMF endemic regions.
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Internal medicine journal · Nov 2024
The future is bright: artificial intelligence for trainee medical officers in Australia and New Zealand.
Given their frontline role in Australia and Aotearoa New Zealand (ANZ) healthcare, trainee medical officers (TMOs) will play a crucial role in the development and use of artificial intelligence (AI) for clinical care, ongoing medical education and research. As 'digital natives', particularly those with technical expertise in AI, TMOs should also be leaders in informing the safe uptake and governance of AI within ANZ healthcare as they have a practical understanding of its associated risks and benefits. However, this is only possible if a culture of broad collaboration is instilled while the use of AI in ANZ is still in its initial phase.