Internal medicine journal
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Internal medicine journal · Nov 2010
Multicenter Study Comparative StudyExploratory study of the 'weekend effect' for acute medical admissions to public hospitals in Queensland, Australia.
To determine whether in-hospital deaths of patients admitted through emergency departments with acute exacerbations of chronic obstructive pulmonary disease (COPD), acute myocardial infarction, intracerebral haemorrhage and acute hip fracture are increased by weekend versus weekday admission (the 'weekend effect'). ⋯ This is the first Australian study on the 'weekend effect' (in a cohort other than neonates), and the first study worldwide to assess specifically the weekend effect among COPD patients. Observed patterns were consistent with overseas research. There was a significant weekend effect for myocardial infarction. Further research is needed to determine whether location (e.g. rural), clinical (e.g. disease severity) and service provision factors (e.g. access to invasive procedures) influence the weekend effect for acute medical conditions in Australia.
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Internal medicine journal · Sep 2010
Multicenter Study Comparative StudyThe four horsemen: clinicopathological correlation in 407 hospital autopsies.
Few previous papers comparing clinical diagnoses with autopsy findings present sensitivities and positive predictive values for individual conditions. The aim of this study is to determine the sensitivity and positive predictive value of current clinical diagnosis both overall and for individual conditions. ⋯ There exists a large burden of clinically undiagnosed and incorrectly diagnosed disease in hospital. Pneumonia, acute myocardial infarction, bowel ischaemia and pulmonary embolism represent important and difficult diagnostic challenges.
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Internal medicine journal · Jul 2010
Multicenter Study Comparative StudyBrief telephone intervention increases testing for osteoporosis in patients treated in emergency departments for wrist fractures.
Previous studies show that identification and treatment of osteoporosis in patients with minimal trauma fractures treated as outpatients are poor. Our aim was to test two interventions designed to increase rates of identification and treatment. This prospective, action research study, using explicit medical record review and scripted telephone interview, was conducted at emergency departments (ED) of three hospitals from April 2007 to February 2008. ⋯ A brief telephone intervention and provision of information pack significantly improved testing rates for osteoporosis after minimal trauma wrist fracture. An ED/clinic-based intervention resulted in low rates of testing. Treatment of clinical osteoporosis remains suboptimal.
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Internal medicine journal · Feb 2010
Multicenter Study Comparative StudyPatients with acute myocardial infarction using ambulance or private transport to reach definitive care: which mode is quicker?
One of the main reasons cited by patients with acute myocardial infarction (AMI) for not using an ambulance was quickness of private transport. ⋯ Although private transportation results in a faster trip to the hospital, quicker definitive care is obtained with the use of ambulance.
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Internal medicine journal · Aug 2009
Multicenter StudyIntravenous aminoglycoside usage and monitoring of patients with cystic fibrosis in Australia. What's new?
The aim of this study was to determine the current situation regarding aminoglycoside use and monitoring in patients with cystic fibrosis (CF) throughout Australia. ⋯ Aminoglycoside dosing regimens have changed since the last survey was carried out in 1999. There has been an increase in the use of once-daily dosing from 54 to 88% of units. The reporting of both ototoxicity and renal toxicity has also increased (from 27 to 75% and from 19 to 65%, respectively). Standardization of management protocols for antibiotic use and patient monitoring may help reduce the risk of cumulative toxicity to aminoglycosides in CF patients.