Internal medicine journal
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Internal medicine journal · Feb 2024
The Western Australian experience of COVID-19 after the borders reopened: evaluation of public health modelling predictions.
Western Australia (WA) serves as a unique global case study on the impact of coronavirus disease 2019 (COVID-19) on an isolated, prepared and highly vaccinated population. This study builds upon the study performed by House et al. through an extended data set. ⋯ The number of hospitalisations and ICU COVID-19 cases were significantly less than predicted, likely due to high population vaccination rates prior to border opening. The main risk factors for COVID-19 severity were incomplete immunisation and ATSI ethnicity.
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Internal medicine journal · Feb 2024
Costs and consequences of over-investigation of minor transfusion reactions.
Adverse transfusion events create a direct cost burden on the healthcare system through increased morbidity, mortality, extra investigations for diagnosis, patient treatment and increased use of hospital resources. Understanding the costs and impact minor transfusion reactions have on the healthcare system presents an opportunity for potential cost savings and improved clinical practice. ⋯ The study demonstrated that unnecessary investigation of minor transfusion reactions adds a significant financial burden to the healthcare system.
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Internal medicine journal · Feb 2024
Beyond the aspirational: Creating the future of health care in Australia.
The context of health care in Australia is shifting very rapidly; more chronic diseases, budgetary stress and the constant threat of the next pandemic and climate change mean that patterns of disease and care are changing, and the workforce is under pressure. Health systems have learned to respond as best they can, but there are many challenges and opportunities for the Australian health care system to plan and implement an evidence-based and sustainable approach to health care delivery in the next decade. ⋯ Here, we outline nine strategies that span principles of integrated, value-based care, with a focus on prevention and quality, the development of a skilled workforce and health-literate population and the use of emerging technologies such as genomics and artificial intelligence. These strategies form a potential path for the Australian health care system to meet the changing requirements of the current decade and take the aspirational visions of the future of health care into an improved, patient-based health system that delivers care in line with best practices.
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Internal medicine journal · Feb 2024
The utility of rested prolactin sampling in the evaluation of hyperprolactinaemia.
Serum prolactin levels may be elevated by venepuncture stress. We investigated the utility of a rested prolactin sample, obtained through an indwelling venous cannula, in preventing the overdiagnosis of hyperprolactinaemia. ⋯ Serum prolactin results are frequently elevated by the stress of venepuncture. Confirmation of pathological hyperprolactinaemia in a rested sample obtained from an indwelling venous cannula is recommended in patients with mild hyperprolactinaemia, particularly when the referral prolactin is less than two times the URL.
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Internal medicine journal · Feb 2024
Observational StudyPreemptive anticoagulation of pulmonary embolism.
Pulmonary embolism (PE) is a life-threatening disease where preemptive anticoagulation is recommended by guidelines for patients with intermediate to high pretest risk of PE. ⋯ The use of preemptive anticoagulation for suspected PE was uncommon and was not influenced by the pretest probability of PE as determined by a validated clinical prediction tool. This may reflect concerns regarding haemorrhagic complications without any clear evidence of benefit. Diagnostic yield of CTPA performed in the ED was low.