Internal medicine journal
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Internal medicine journal · Jun 2014
Disabling disease codes predict worse outcomes for acute medical admissions.
Concurrent with an extension in longevity, a prodrome of ill-health ('disability' identifiable by certain International Classification of Disease (ICD) 9/ICD10 codes) predates the acute emergency presentation. To date, no study has assessed the effect of such 'disability' on outcomes of emergency medical admissions. ⋯ Disability burden, irrespective of organ system at emergency medical admission, independently predicts worse outcomes and a longer in-hospital stay.
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Māori have known health disparities that may be addressed through increasing the cultural competency of New Zealand's medical workforce. There is a paucity of Māori health professionals choosing paediatrics or adult medicine as a career and the factors influencing their career decision are yet to be explored. ⋯ Mentoring provides an opportunity to attract Māori into paediatric and adult physician training. The use of existing mentoring programmes could facilitate in expanding Māori RACP workforce development. This extended Māori workforce would have benefits for the health of New Zealand as a whole.
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Internal medicine journal · May 2014
Multicenter StudySpontaneous pneumothorax; a multicentre retrospective analysis of emergency treatment, complications and outcomes.
Spontaneous pneumothorax can be managed initially by observation, aspiration or chest drain insertion. ⋯ Pneumothorax drainage is associated with substantial morbidity including prolonged air leak. As PSP appears to be well tolerated in younger people even with large pneumothoraces, conservative treatment in this subgroup may be a viable option to improve patient outcomes, but this needs to be confirmed in a clinical trial.
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Internal medicine journal · May 2014
Early predictors of colectomy and long-term maintenance of remission in ulcerative colitis patients treated using anti-tumour necrosis factor therapy.
Anti-tumour necrosis factor (TNF) agents are used as induction and maintenance therapy in ulcerative colitis (UC) refractory to standard therapy and as rescue therapy in acute severe UC (ASUC). ⋯ Anti-TNF therapy is effective in both refractory and ASUC. We argue that early anti-TNF therapy may improve outcome in UC.