Internal medicine journal
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Internal medicine journal · Aug 2011
Comparative StudyPre-hospital oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease.
High concentration oxygen is commonly administered during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The aim of this study was to determine the association between oxygen, severity markers and poor outcomes in AECOPD. ⋯ In AECOPD high flow oxygen in the ambulance is associated with poor clinical outcomes. A number of easily identified markers of chronic disease severity indicate an increased risk of a poor clinical outcome.
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Internal medicine journal · Aug 2011
Case ReportsUse and disclosure of genetic information without consent: a decision-making tool for health practitioners--who, when, why and how?
As a result of legislative changes to the Privacy Act 1988 (Cth), Australian health practitioners in the private sector are now permitted to use or disclose patients' genetic information, without their consent, in circumstances where the health practitioner reasonably believes that doing so is necessary to lessen or prevent a serious threat to the life, health or safety of a genetic relative. ⋯ The Guidelines establish when, by whom and in what manner, use or disclosure of genetic information may take place. The Guidelines outline the factors that health practitioners should consider when determining whether use or disclosure is necessary to lessen or prevent a serious threat to an individual's life, health or safety.
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Internal medicine journal · Aug 2011
Comparative StudyPrevalence and predictors of premature discontinuation of dual antiplatelet therapy after drug-eluting stent implantation: importance of social factors in Asian patients.
Premature discontinuation of antiplatelet therapy is an independent predictor of late stent thrombosis. We sought to determine the prevalence and predictors of premature discontinuation of antiplatelet therapy after drug-eluting stent implantation among patients in Asia. ⋯ Among Asian patients who have undergone drug-eluting stent implantation, 12.8% discontinued dual antiplatelet therapy within 12 months. Living alone is associated with a fivefold increase in risk of premature drug discontinuation.
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Internal medicine journal · Aug 2011
Randomized Controlled Trial Comparative StudyAssessing PaCO2 in acute respiratory disease: accuracy of a transcutaneous carbon dioxide device.
Pulse oximetry non-invasively assesses the arterial oxygen saturation of patients with acute respiratory disease; however, measurement of the arterial partial pressure of carbon dioxide (PaCO(2)) requires an arterial blood gas. The transcutaneous partial pressure of carbon dioxide (PtCO(2) ) has been used in other settings with variable accuracy. We investigated the accuracy of a PtCO(2) device in the assessment of PaCO(2) in patients with asthma and suspected pneumonia attending the emergency department. ⋯ A PtCO(2) device was accurate in the assessment of PaCO(2) in patients with acute severe asthma and suspected pneumonia when compared with an arterial blood gas. These bedside monitors have the potential to improve patient care by non-invasively monitoring patients with acute respiratory disease at risk of hypercapnia.