Internal medicine journal
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Internal medicine journal · Jul 2022
Aggregation of autoimmunity in extended families of people with autoimmune Addison's disease.
Autoimmunity accounts for 90% of cases of primary adrenal insufficiency (Addison disease (AD)). Affected people present a significant co-occurrence of autoimmune conditions; hence, clustering of autoimmunity is also predicted among their relatives. ⋯ Considerable prevalence of autoimmune conditions in relatives of people with AD confirms substantial risk of autoimmunity, especially in females and relatives of patients affected by multiplex autoimmunity. Our data corroborate the recommendation of active screening for autoimmune disorders, particularly thyroid disease, among AD family members.
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Internal medicine journal · Jul 2022
Evaluation of pleural fluid cytology for the diagnosis of malignant pleural effusion: a retrospective cohort study.
Cytological examination of pleural fluid has good specificity, but imperfect sensitivity for the diagnosis of malignant pleural effusion (MPE). Published estimates of sensitivity vary and predictors of false negative cytology are not well established. ⋯ Sensitivity of pleural fluid cytology was greatest in primary lung and breast cancer, and lowest in mesothelioma. Clinicians should be alert to false negative results when suspecting mesothelioma or if pleural thickening is present.
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Internal medicine journal · Jul 2022
Patient perceptions of current and potential inflammatory bowel disease diagnostic and monitoring tests.
Less invasive inflammatory bowel disease (IBD) tests are increasingly being incorporated into clinical practice as adjuncts to endoscopy to monitor disease activity and guide optimal care. Little is known about patient perspectives of these tests. ⋯ Patients with IBD preferred any tests less invasive than colonoscopy. An explanation by referring doctor enhanced patients' understanding, but did not necessarily influence their level of comfort or worry.
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Internal medicine journal · Jul 2022
The relationship between pancreatic cancer and type 2 diabetes: the Fremantle Diabetes Study Phase I.
Pancreatic cancer incidence was double (incidence rate ratio 2.06) in community-based adults with (n = 1291) versus without (n = 5158) type 2 diabetes followed for up to 25 years in the Fremantle Diabetes Study Phase 1. Sustained higher fasting plasma glucose reflecting insulin resistance and fewer comorbidities were statistically significant risk factors in the cohort with diabetes. Past pancreatitis was an aetiologically significant determinant in the cohort as a whole.
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Internal medicine journal · Jul 2022
Professionalism and clinical short answer question marking with machine learning.
Machine learning may assist in medical student evaluation. This study involved scoring short answer questions administered at three centres. ⋯ In the scoring of 3-mark professionalism questions, as compared with clinical questions, machine learning had a lower classification accuracy (P < 0.05). The role of machine learning in medical professionalism evaluation warrants further investigation.