Internal medicine journal
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Internal medicine journal · Jan 2008
Multicenter StudyDeviation from published guidelines in the management of primary spontaneous pneumothorax in Australia.
There are a several published guidelines recommending treatment pathways for patients with primary spontaneous pneumothorax (PSP). Little is known about how these patients are actually treated in Australia. ⋯ In Australia, there is considerable deviation from published guidelines for the management of PSP. In light of the lack of high-quality evidence to assist in choosing treatment approaches, a randomized controlled trial of management strategies is recommended.
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Internal medicine journal · Aug 2007
Case Reports Multicenter StudyThrombotic microangiopathy from Australian brown snake (Pseudonaja) envenoming.
Australian brown snake (genus Pseudonaja) envenoming causes a venom-induced consumptive coagulopathy (VICC). A proportion of cases go on to develop thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic haemolytic anaemia (MAHA) and acute renal failure (ARF). ⋯ Thrombotic microangiopathy resulting from brown snake bite appears to have a good prognosis and management should focus on early antivenom therapy and supportive care including dialysis. The role of plasmapheresis is yet to be defined.
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Internal medicine journal · Oct 2005
Multicenter Study Comparative StudyOrbital decompression in Graves' orbitopathy: efficacy and safety.
Vision-threatening compressive optic neuropathy occurs in a minority of patients with Graves' orbitopathy. Surgical orbital decompression, systemic glucocorticoids and orbital irradiation are treatment options. Orbital decompression is being performed on an increasing number of patients for other indications such as corneal exposure and disfiguring proptosis. ⋯ Orbital decompression is a safe procedure and effective in improving vision in compressive optic neuropathy. It is effective in reducing proptosis, therefore improving exposure keratopathy and cosmesis. However, new or worsened diplopia is a significant postoperative complication, and subsequent strabismus surgery might be required. This is an important consideration, especially for patients undergoing surgery for non-optic neuropathy indications.
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Internal medicine journal · Sep 2005
Multicenter Study Comparative StudyEpiglottitis in Sydney before and after the introduction of vaccination against Haemophilus influenzae type b disease.
Acute epiglottitis due to infection with Haemophilus influenzae type b (Hib) is much less common in children following the introduction of Hib vaccination; however, adult epiglottitis cases have not decreased. In addition, epiglottitis hospitalizations are consistently more numerous than notifications and the reason for this is not clear. ⋯ Acute epiglottitis hospitalizations in the current Hib vaccine era are predominantly in adults, and rarely are Hib or other causative organisms identified, although microbiological data are often incomplete. The discrepancy between hospitalization and notification data appears to be due to misclassification of hospitalization records.
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Internal medicine journal · Sep 2005
Randomized Controlled Trial Multicenter Study Comparative StudyGlargine is superior to neutral protamine Hagedorn for improving glycated haemoglobin and fasting blood glucose levels during intensive insulin therapy.
To compare glycaemic control and symptomatic hypoglycaemia rates with glargine versus neutral protamine Hagedorn (NPH) in poorly controlled type 1 diabetes patients. ⋯ Glargine is superior to NPH for improving HbA(1c) and FBG levels during intensive insulin therapy in patients with type 1 diabetes, and is associated with less severe nocturnal hypoglycaemia.