Internal medicine journal
-
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.
-
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.
-
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.
-
Internal medicine journal · Mar 2024
Mitochondrial disease in New Zealand: a nationwide prevalence study.
The complexities of mitochondrial disease make epidemiological studies challenging, yet this information is important in understanding the healthcare burden and addressing service and educational needs. Existing studies are limited to quaternary centres or focus on a single genotype or phenotype and estimate disease prevalence at 12.5 per 100 000. New Zealand's (NZ) size and partially integrated national healthcare system make it amenable to a nationwide prevalence study. ⋯ Within the limitations of this study, comparison to similar prevalence studies performed by specialist referral centres suggests mitochondrial disease is underdiagnosed in NZ. This highlights a need for improved education and referral pathways for mitochondrial disease in NZ.
-
Internal medicine journal · Mar 2024
A comparison of the outcomes of pulmonary versus extrapulmonary extensive-stage small cell carcinoma.
Extrapulmonary small cell carcinomas (EPSCCs) are rare cancers, comprising 0.1-0.4% of all cancers. The scarcity of EPSCC studies has led current treatment strategies to be extrapolated from small cell lung cancer (SCLC), justified by analogous histological and clinical features. ⋯ EPSCC and SCLC appeared to have comparable OS and treatment outcomes. However, the wide range of OS in EPSCC highlights the need for an improved understanding of its genomics to explore alternative therapeutics.