Internal medicine journal
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Internal medicine journal · Dec 2024
Comparison of cardiovascular risk prediction in type 1 diabetes: an Australian viewpoint.
Cardiovascular disease (CVD) is a significant burden in individuals with type 1 diabetes mellitus (T1DM). Yet the optimal method of CVD risk stratification remains uncertain. We found that the new Australian CVD risk calculator could overestimate risk category compared with the Steno Type 1 Risk Engine and underestimate risk category compared with the new Swedish/Scottish prediction tool, both of which were validated for T1DM. More research is needed to derive a CVD risk assessment pathway for individuals with T1DM in Australia.
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Internal medicine journal · Dec 2024
Statewide neurology inpatient whole body and brain 18F-fluorodeoxyglucose positron emission tomography utilisation patterns demonstrate avenues for optimisation.
18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) can provide unique insights; however, access may be difficult. In this 2-year statewide study of all neurology inpatient admissions, 27.9% (41/147) of PET (any field of view) demonstrated significant abnormalities. At sites without on-site PET access, the proportion of patients receiving PET was lower (P < 0.01), and the time from admission to receiving PET was longer (P = 0.018), as compared to those with on-site access. Investigation of strategies to improve access is warranted.
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This article considers claims to ownership over genomic data and implications for data sharing and research. There are various arguments for vesting ownership in individuals, but little supporting authority. However, policies such as privacy law and informed consent provide alternative methods of protecting individuals. The conclusions highlight the importance of clear channels of communication with patients.
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Internal medicine journal · Dec 2024
Clinical outcomes of patients with non-tuberculous mycobacterial pulmonary disease in Auckland, New Zealand.
This review of non-tuberculous mycobacterial pulmonary disease over an 11-year period identified 87 patients (74% women, mean age 66 years). Mycobacterium avium complex was isolated in 86% of patients. Antibiotics were commenced in 52% of patients; however, treatment was poorly tolerated with 36% terminating prematurely. Mortality was significant; death occurred in 31% of patients, with no relationship between death and treatment.
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Internal medicine journal · Dec 2024
Characteristics of paracetamol poisoning in a local health network and consistency of hospital management with national guidelines.
The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4-month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. ⋯ Although most were managed in accordance with national guidelines, there were deficiencies in documentation of the poisoning details and patient weight as well as cases of underdosing of the antidote. Quality improvement initiatives are needed.