Internal medicine journal
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Internal medicine journal · Jun 2022
Appropriate prescribing of azithromycin for community-acquired pneumonia.
Azithromycin is prescribed for atypical antimicrobial cover in severe community-acquired pneumonia. Inappropriate azithromycin administration incurs unnecessary financial costs, exacerbates antimicrobial resistance and risks QTc interval prolongation leading to cardiac arrhythmias. The present study demonstrated that a majority of patients were prescribed azithromycin without having electrocardiograms to assess the QTc interval and without meeting criteria for severe community-acquired pneumonia based on CURB-65 score.
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Internal medicine journal · Jun 2022
Case ReportsUnusual presentations of central nervous system myeloid sarcoma.
Myeloid sarcoma (MS), also termed 'chloroma' or 'granulocytic sarcoma', is a tumour mass consisting of myeloid blasts occurring at an anatomical site other than the bone marrow. MS occurs in up to 8% of patients with acute myeloid leukaemia. ⋯ We present a case series of patients that presented to a tertiary hospital with MS affecting the central nervous system over a 4-month period. These three cases demonstrate the vast spectrum of clinical presentations of MS and, furthermore, show rare examples of intramedullary spinal cord involvement and disseminated intraparenchymal brain disease.
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Internal medicine journal · Jun 2022
Outcomes Of Non-Cystic Fibrosis Related Bronchiectasis Post Lung Transplantation.
Lung transplantation is a recognised treatment for end-stage lung disease due to bronchiectasis. Non-cystic fibrosis (CF) bronchiectasis and CF are often combined into one cohort; however, outcomes for non-CF bronchiectasis patients vary between centres, and in comparison with those for CF. ⋯ Bronchiectasis patients in the present study had a lower 5-year survival and poorer outcomes in comparison with other indications including CF. Bronchiectasis should be considered a separate entity to CF in survival analysis.
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Internal medicine journal · Jun 2022
Too much sugar does not just make us fat; it can also make us sick.
The post-COVID-19 care era is likely to see a burgeoning of metabolic dysfunction and chronic kidney disease. Attention to self-care, including nutrition, will underpin the management of those affected. The damaging effects of sugar-sweetened beverages are well documented and profound and counter many accepted medical treatments. Government leadership is urgently required with explicit and strong messaging to avoid sugar-sweetened beverages.
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Internal medicine journal · Jun 2022
The AMA supports all doctors in relation to voluntary assisted dying.
This article outlines the Australian Medical Association's (AMA) current policy on voluntary assisted dying (VAD), arguing that, when read in good faith in its entirety as intended, the policy lacks neutrality or balance. As written, it is a wide-ranging policy reflecting the diversity of views among medical professionals that still exists on the issue of VAD. While recognising that relevant legislation is a matter for governments and society, the policy advocates for the protection of doctors and patients, whether they choose to participate in VAD or not. Consistent with a proper interpretation of the policy as a whole, the AMA has been active in supporting the VAD legislative process, implementation and the practitioners involved including providing practical guidance now that legislation has been passed in several jurisdictions.