Internal medicine journal
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Internal medicine journal · Mar 2022
Real-world experience with limited screening for occult malignancy in patients presenting with spontaneous venous thromboembolism: a single-centre, retrospective cohort study.
Spontaneous venous thromboembolism (VTE) may represent the first manifestation of previously undiagnosed malignancy; however, contemporary international guidelines call for a limited approach to screening for malignancy in such patients. This retrospective cohort study of 328 patients presenting to the Auckland City Hospital Thrombosis Unit identified 17 patients who were subsequently diagnosed with some form of malignancy within 12 months of their presentation. Review of their history, physical examination and limited age and gender-appropriate cancer screening investigations as described by the National Institute for Clinical Excellence and International Society of Thrombosis and Haemostasis guidelines revealed that all 17 would have been safely diagnosed by the 'limited' screening approach endorsed by these guidelines, thus presenting a 'real-world' basis for clinicians to pursue 'limited' screening for malignancy in their everyday practice in patients with spontaneous VTE.
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Internal medicine journal · Mar 2022
Case ReportsCough as a clinical manifestation of large vessel vasculitis.
Cough is not a widely recognised symptom of large vessel vasculitides. If not promptly diagnosed and treated, large vessel vasculitis can have serious clinical consequences. We present the case of a 76-year-old man who presented with a subacute history of persistent dry cough, was found to have extensive aortitis on imaging, and experienced rapid resolution of symptoms with immunosuppression.
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Inflammatory bowel disease (IBD) patients living in regional or remote Queensland are often disadvantaged by limited access to IBD specialist care. Telehealth clinics could potentially address this disparity and improve patient outcomes. ⋯ The RBWH IBD telehealth clinics have shown that telemedicine is well received and can be used successfully to deliver IBD specialist care to patients living in regional or remote areas.
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Internal medicine journal · Mar 2022
Burnout in rehabilitation medicine trainees: a call for more research.
Burnout is recognised as a significant occupational hazard for medical professionals. For graduate trainees, across various medical specialties, there is growing evidence burnout results in personal harm and reduces the quality of patient care. Rehabilitation medicine, with its challenge of emotional exhaustion bought about by greater involvement in patient psychosocial well-being over a prolonged period, is significantly under-represented in research into burnout prevalence, impact and prevention strategies. We argue the lack of any evidence base in the Australian healthcare context negatively impacts the ability of training organisations to appropriately support trainees experiencing burnout.
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Internal medicine journal · Mar 2022
Mixed gender accommodation: prevalence, trend over time and vulnerability of older adults.
Admitting male and female patients to the same room compromises the safety of female patients and violates the rights of all patients. We demonstrate that mixed bedding is common (47.22% of admissions), increasing and disproportionately affects vulnerable older patients in a large New Zealand hospital from 2011 to 2019 (n = 160 048). Eliminating mixed bedding should be a priority for our hospital system.