Internal medicine journal
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Internal medicine journal · Aug 2021
Identifying community chronic kidney disease risk profile utilising general practice clinical records and spatial analysis: an approach to inform policy and practice.
Chronic kidney disease (CKD) causes a significant health burden in Australia, and up to 50% of Australians with CKD remain undiagnosed. ⋯ This study demonstrated a new approach to explore the spatial variation of CKD risk at a community level, and implementation of a risk prediction model into a clinical setting may aid in early detection and increase disease awareness in regions of unmet CKD care.
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Internal medicine journal · Aug 2021
The impact of an online adult headache guideline on headache referrals to neurology clinic.
Headache is a common problem in primary care and one of the main reasons general practitioners (GP) consult the neurology service. We developed an online adult headache guideline (Supporting Information Appendix S1) for the greater Wellington Region as a resource for GP to guide identification of concerning headaches, initiation of prophylactic medications for migraine and management of analgesic overuse headache. ⋯ The launch of an online headache guideline was associated with a reduction in demand on neurology service. Further education could improve the utilisation of this guideline, to avoid delays in prophylactic treatment and reduce the harm of medication overuse.
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Internal medicine journal · Aug 2021
Strongyloides stercoralis seropositivity is not associated with increased symptoms in a remote Aboriginal community.
Strongyloides stercoralis is a soil-transmitted helminth, endemic in remote Aboriginal and Torres Strait Islander communities in northern Australia with estimates of prevalences up to 60%. Hyperinfection in the setting of immunosuppression is a rare, but well recognised cause of significant morbidity and mortality. However, the morbidity associated with chronic uncomplicated infection is less well characterised. ⋯ We found no evidence to suggest that S. stercoralis seropositivity was associated with increased symptoms when compared to matched seronegative controls. Treatment with ivermectin did not reduce symptoms in seropositive cases. Without evidence to support that population-based screening or treatment programmes reduce symptoms, the emphasis must remain on identifying and managing those few individuals with immunosuppression that predisposes them to potentially life-threatening hyperinfection.
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Internal medicine journal · Aug 2021
Observational StudyTelehealth in Australian cardiology: Insight into factors predicting the use of telephone versus video during the COVID-19 pandemic.
The use of telehealth has increased dramatically in Australia in 2020 as a pragmatic response to the COVID-19 pandemic; however, differences between telehealth modalities have not been established. ⋯ During COVID-19, we increased consultation volumes without adverse patient outcomes. We identified factors influencing the choice of telemedicine modality which did not translate into differences in mortality or ED presentations. Telemedicine is a growing platform with an important role of facilitating access to healthcare for diverse patient groups.