Internal medicine journal
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Internal medicine journal · Aug 2019
Multicenter Study Comparative StudyComparison between gallium-68 citrate positron emission tomography-computed tomography and gallium-67 citrate scintigraphy for infection imaging.
Preliminary studies have reported promising results for the utility of gallium-68 (Ga-68) citrate positron emission tomography-computed tomography (PET-CT) for infection imaging. This technique offers reduced radiation dose to patients, shorter time between injection and imaging and reduced time for image acquisition compared to the 'gold standard' nuclear imaging technique: gallium-67 (Ga-67) citrate scintigraphy. ⋯ The sensitivity and specificity of Ga-68 citrate PET-CT were found to be consistently lower than Ga-67 citrate scintigraphy. Additionally, due to the insufficient level of confidence of the reporting physicians for the Ga-68 citrate PET-CT, this modality could not currently be recommended to replace Ga-67 citrate scintigraphy for routine clinical use.
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Internal medicine journal · Mar 2019
Multicenter StudyBurden of skin disease in two remote primary healthcare centres in northern and central Australia.
The burden of skin infections across all age groups in remote Australian Indigenous communities is currently unknown. In a retrospective audit of 439 residents from two remote communities presenting to health clinics, skin conditions were the most common reason for presentation (1603/7392, 22%) and 330/439 (75%) residents presented at least once with a skin infection. Skin infections are an under-appreciated and dominant reason for presentation to primary healthcare centres in these indigenous communities and public health campaigns to address this should incorporate all age groups.
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Internal medicine journal · Mar 2019
Multicenter StudyOutcomes of endovascular thrombectomy with and without bridging thrombolysis for acute large vessel occlusion ischaemic stroke.
Endovascular thrombectomy (EVT) for management of large vessel occlusion (LVO) acute ischaemic stroke is now current best practice. ⋯ Our study supports the current practice of administering i.v. alteplase before endovascular therapy.
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Internal medicine journal · Jan 2019
Multicenter StudySubstantial variation exists in spirometry interpretation practices for airflow obstruction in accredited lung function laboratories across Australia and New Zealand.
Spirometry forms the foundation investigation for the diagnosis and monitoring of common pulmonary conditions. However, potential variation in spirometry interpretation for airflow obstruction may impact subsequent clinical management. ⋯ Significant heterogeneity in spirometry interpretation for airflow obstruction exists across Australian and New Zealand accredited lung function laboratories. Lack of standardisation may translate into clinically appreciable differences for the diagnosis and management of common respiratory conditions. Ongoing discussion regarding formal standardisation is required.
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Internal medicine journal · Sep 2018
Multicenter StudyAge-adjusted cut-off using the IL D-dimer HS assay to exclude pulmonary embolism in patients presenting to emergency.
The ADJUST-PE study showed that an age-adjusted D-dimer (AADD) (age years × 10 ng/mL if >50 years) combined with an unlikely pre-test probability (PTP) can increase the proportion of older patients in whom pulmonary embolism (PE) can be safely excluded, but the IL D-dimer HS assay was not assessed. To assess the ability of the IL D-dimer HS assay to exclude PE using the AADD. ⋯ The absolute increase in efficiency of an AADD compared to conventional cut-off using the IL D-dimer HS assay is modest (~10%) and requires prospective validation. Modifying our cut-off to 230 ng/mL and systematic implementation of a clinical algorithm, including D-dimer testing and PTP, is likely a more important first step.