Internal medicine journal
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Internal medicine journal · Oct 2021
Randomized Controlled Trial Observational StudyThe impact of weekend admission and changes in treating team on patient flow and outcomes in adults admitted to hospital with community-acquired pneumonia.
The effect of workflow factors, such as timing of admission and changes in treating team, on patient outcomes remains inconclusive. ⋯ These results suggest workflow factors can negatively impact both health service and patient outcomes. Systems interventions aimed at improving out of hours service and reducing changes in treating team should be considered.
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The gut microbiota has a key role in the maintenance of good health, and in the pathogenesis of gastrointestinal diseases. These conditions include the inflammatory bowel diseases, colorectal cancer, coeliac disease and metabolic liver disease. Although the nature of the microbial disturbance in these conditions has not been fully characterised, this has not prevented the development of microbially based therapies. ⋯ Probiotics have a more limited proven role. Faecal microbiota transplantation is of proven therapeutic benefit in recurrent C. difficile disease and ulcerative colitis. We review the current literature for microbiota-targeted therapies in gut disorders.
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Internal medicine journal · Oct 2021
Dialysis and driving: An anonymous survey of patients receiving dialysis for end stage kidney disease.
Driving is a complex task requiring multiple cognitive domains and the musculoskeletal system. Cognitive dysfunction is associated with driving impairment. Dialysis patients are known to have a high prevalence of cognitive impairment and other comorbidities, and may be at risk of driving impairment. No Australian guidelines address driving safety in dialysis patients. ⋯ Dialysis patients are at risk of driving impairment based on self-reported questionnaire responses. Discrepancies between patients' perceptions and objective markers were apparent. Further research into appropriate risk assessments, as well as development of guidelines to aid in determining driving safety in dialysis patients, is needed.
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Internal medicine journal · Oct 2021
Feasibility of an online cognitive rehabilitation program in patients with a haematological malignancy undergoing autologous stem cell transplantation.
Chemotherapy-related cognitive impairment (CRCI) is a known adverse event that can impact cancer survivors, resulting in long-standing effect on quality of life and activities of daily living. Currently, there is limited knowledge regarding the aetiology and therapy for CRCI. Although CRCI following autologous stem cell transplantation (AuSCT) is emerging as a potentially significant concern for patients with underlying haematological malignancies, it is an area that requires further research. ⋯ While there appeared to be a low incidence of significant CRCI in our patient population, the incorporation of CRP in survivorship care appeared to be feasible. A larger randomised study examining the efficacy of CRP should be further explored.
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Internal medicine journal · Oct 2021
The impact of COVID-19 telehealth on outpatient test completion.
Pathology and imaging tests are frequently requested in the outpatient setting despite historically poor completion rates. The impact of COVID-19 telehealth on test completion rates is unknown. ⋯ The COVID-19 pandemic and telehealth transition have resulted in more frequent pathology and imaging requests but fewer test completion in the outpatients setting. This study has identified new clinical risks associated with the abrupt transition to telehealth during COVID-19 that should be explored in future studies and appropriately mitigated.