Internal medicine journal
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Internal medicine journal · Jan 2025
Safety of abdominal paracentesis in hospitalised patients receiving uninterrupted therapeutic or prophylactic anticoagulants.
Abdominal paracentesis is a frequently performed procedure in hospitalised patients with ascites. Concurrently, most hospitalised adult patients receive pharmacologic anticoagulation, either for therapeutic purposes or prophylactically to prevent venous thromboembolism. Despite this, minimal evidence exists to guide management of anticoagulant therapy pre- and post-paracentesis. ⋯ Performance of abdominal paracentesis in patients receiving therapeutic or prophylactic anticoagulation appears to be safe regardless of whether anticoagulation was interrupted periprocedurally, with low rates of bleeding complications, thrombotic complications or need for red blood cell transfusions post-paracentesis.
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Granulomatous amoebic encephalitis is a rare but likely under-recognised form of subacute, usually fatal, encephalitis. We present an illustrative case report and literature review of Australian cases, summarising clinical features, diagnostic methods, treatment and outcomes.
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Internal medicine journal · Jan 2025
Uptake of gonadotrophin-releasing hormone agonists for prevention of premature ovarian insufficiency in women undergoing chemotherapy: an Australian single-centre study.
Treatment-related premature ovarian insufficiency (POI) can result in early-onset menopause and infertility. ⋯ One-quarter of eligible patients did not have a documented discussion regarding goserelin, despite the negative consequences of POI. Efforts are needed to increase the discussion and use of goserelin in all premenopausal women regardless of their fertility interests and to ensure timely administration in those who choose to receive it.
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Internal medicine journal · Jan 2025
Results of an Australian trial of an automated insulin delivery (AID) system and other studies support likely benefit of AID use for many Australian adults with type 1 diabetes.
Less than 20% of Australians with type 1 diabetes (T1D) meet recommended glucose targets. Technology use is associated with better glycaemia, with the most advanced being automated insulin delivery (AID) systems, which are now recommended as gold-standard T1D care. ⋯ Insulin pumps are not subsidised for most Australian adults with T1D. We advocate change.
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Internal medicine journal · Jan 2025
Rationale, objectives and design of a national prospective database for idiopathic inflammatory myopathies: the Australian Myositis Registry.
Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune diseases characterised by inflammation of skeletal muscle and other organ systems. They have high morbidity and mortality but, in part because of their rarity and heterogeneity, improving understanding and outcomes remains challenging. To address these problems, numerous IIM registries exist globally, but no national registry yet exists in Australia. ⋯ The AMR is the first nationwide registry in Australia for patients with IIMs and one of the very few national registries for IIMs globally. It aims to provide valuable insight into the epidemiology and clinical experience of IIMs in Australia to help address multiple research agendas.