Internal medicine journal
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Internal medicine journal · Nov 2001
Survival on long-term oxygen therapy in chronic airflow limitation: from evidence to outcomes in the routine clinical setting.
Two previous randomized controlled trials (RCT) demonstrated that the administration of long-term oxygen therapy (LTOT) improved survival in selected patients with hypoxic chronic obstructive pulmonary disease (COPD) or chronic airflow limitation (CAL). ⋯ In routine practice, survival of unselected CAL patients with multiple comorbidities is less than that reported in the original RCT.
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Internal medicine journal · Nov 2001
ReviewIncreasing relevance of pharmacogenetics of drug metabolism in clinical practice.
Much of the individual variation in drug response is due to genetic drug metabolic polymorphisms. Clinically relevant examples include acetylator status; cytochrome P450 2D6, 2C9 and 2C19 polymorphisms; and thiopurine methyltransferase deficiency. It is important to be aware of which drugs are subject to pharmacogenetic variability. In the future, population-based pharmacogenetic testing will allow more individualized drug treatment and will avoid the current empiricism.
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Internal medicine journal · Nov 2001
Comment Letter Case ReportsSpontaneous coronary dissection following exertion: support for a hypothesis.
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Internal medicine journal · Sep 2001
ReviewHuman immunodeficiency virus-hepatitis C coinfection: swapping new problems for newer ones.
Recent successes in HIV therapy have uncovered other health problems for HIV-infected individuals. Hepatitis C has become an especially significant problem, partly due to its faster progression in an immunocompromised setting. In addition, the higher viral loads in coinfected patients likely result in more efficient perinatal and perhaps even sexual transmission. ⋯ A major concern is the potential inactivation of certain thymidine analogues by ribavirin. Some antiretroviral therapies, such as ritonavir, indinavir and nevirapine, may enhance liver toxicity in coinfected patients and should be avoided if possible. The role of chronic low-grade liver function abnormalities remains uncertain and requires further investigation.
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Recent studies have suggested there are a large number of potentially preventable deaths in Australian hospitals. ⋯ There is a high incidence of serious vital sign abnormalities in the period before potentially preventable hospital deaths. These antecedents may identify patients who would benefit from earlier intervention.