Internal medicine journal
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Internal medicine journal · Mar 2024
Risk factors for malignancy and serious infection in patients with Inflammatory Bowel Disease: a retrospective analysis.
Patients with inflammatory bowel disease (IBD) are at increased risk of malignancy and infection compared to the general population. ⋯ Factors including ileocolonic CD and increasing IBD duration were associated with higher malignancy risk in this cohort. Compared with non-exposure, patients exposed to thiopurines were not at increased risk of malignancy or serious infection. Similarly, patients exposed to anti-TNF treatment did not experience increased rates of malignancy or serious infection compared to patients not exposed to this treatment.
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Internal medicine journal · Mar 2024
Serum lipase in acute pancreatitis associated with hypertriglyceridaemia.
The incidence of hypertriglyceridaemic pancreatitis is increasing. Hypertriglyceridaemia may be associated with false lowering of serum amylase and lipase in vitro. ⋯ Serum lipase levels were in the normal range in two patients (7.7%) and less than three times the upper end of the reference interval in 11 individuals (42%). Awareness of the potential for normal and nonsignificantly elevated serum lipase levels in the setting of hypertriglyceridaemic pancreatitis is important to avoid a missed diagnosis, to enable appropriate short- and long-term management and to prevent recurrent episodes.
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Internal medicine journal · Mar 2024
COVID-19 vaccination: are more jabs needed or are we now immune?
As the COVID-19 pandemic has progressed, it has become apparent that COVID-19 vaccination has limited impact on SAR-CoV-2 transmission and provides only short-term protection against acquiring infection, but more robust protection against severe disease and death. As a result, vaccinated people remain susceptible to SARS-CoV-2 infection but are less likely to experience severe outcomes. Studies show that immunity derived from the combination of vaccination and natural infection, so-called hybrid immunity, is superior to that provided by vaccination or natural infection alone. ⋯ The predominance of the Omicron strain initially led to the development of bivalent vaccines containing both the Wuhan strain and Omicron variants. Currently, vaccines containing the original Wuhan strain of spike protein are being phased out, and new COVID-19 vaccines based exclusively on the Omicron strain XBB have become available in Australia. This article explores the question of whether further doses will be required from 2024 onwards and, if so, who should receive them?
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Internal medicine journal · Mar 2024
Reporting hypoglycaemia as a hospital-acquired complication (HAC): assessing biochemical and clinical validity.
Given treatment-related hypoglycaemia in hospitals can lead to adverse outcomes, the Australian Commission on Safety and Quality in Health Care has included hypoglycaemia as a reportable hospital-acquired complication (HAC) with financial disincentives. However, the designation of a hypoglycaemia HAC relies on clinical coding without a defined glucose threshold or clinical context. We assessed the biochemical validity and clinical relevance of a hypoglycaemia HAC. ⋯ Given safety and cost implications, the designation of hypoglycaemia HAC requires a standardised definition incorporating a biochemical threshold and clinical context. We propose a clinically relevant definition of hypoglycaemia HAC to promote safe diabetes care.
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Internal medicine journal · Mar 2024
Left ventricular assist devices for treatment of refractory advanced heart failure: the Western Australian experience.
Left ventricular (LV) assist devices (LVADs) can prolong survival and improve quality of life in end-stage heart failure. ⋯ Excellent outcomes can be achieved with LVADs in appropriately selected patients.