Internal medicine journal
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Internal medicine journal · May 2012
Proton pump inhibitors and diarrhoea related to Clostridium difficile infection in hospitalised patients: a case-control study.
The incidence and disease severity of Clostridium difficile infection are rising. There is increasing evidence of a potential association between proton-pump inhibitors (PPI) and C. difficile infection. ⋯ A restricted analysis on those who had exposure to antibiotics within 3 months before the onset of diarrhoea did not change the negative association between PPI exposure and PCR-proven C. difficile infection. Long-term PPI usage and intensity of PPI exposure prior to onset of diarrhoea were not significantly associated with C. difficile infection.
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Internal medicine journal · May 2012
Leukaemic transformation of Philadelphia chromosome-negative myeloproliferative neoplasms: are Asian patients different?
Leukaemic transformation (LT) is rare in the natural history of Philadelphia(Ph) chromosome-negative myeloproliferative disorders (MPD), and has a dismal prognosis. Little literature is available on Asian patients. ⋯ LT of Ph chromosome-negative MPD is rare and uniformly fatal. Despite chemotherapy, survival was poor, and patients succumbed to refractory disease and infections. Asian patients did not have a more favourable outcome. It remains to be investigated whether upfront stem cell transplant may be a treatment option.
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Internal medicine journal · May 2012
Staphylococcus aureus bacteraemia at Alice Springs Hospital, Central Australia, 2003-2006.
Infectious diseases remain the leading cause of death at Alice Springs Hospital (ASH) and Staphylococcus aureus bacteraemia (SAB) is the second most common bloodstream infection. Non-multidrug-resistant, methicillin-resistant S. aureus (nmMRSA) is endemic to the region. ⋯ Indigenous Australians have the highest reported incidence rate of SAB worldwide. This reflects the socioeconomic disadvantage experienced by indigenous Australians whose living conditions predispose to pathogen transmission and limits opportunities to maintain adequate skin hygiene.
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Internal medicine journal · May 2012
Meta AnalysisDiabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies.
This study examined the association of diabetes with the onset of dementia (including Alzheimer's disease (AD), vascular dementia (VD) and any dementia) and mild cognitive impairment (MCI) by using a quantitative meta-analysis of longitudinal studies. EMBASE and MEDLINE were searched for articles published up to December 2010. All studies that examined the relationship between diabetes and the onset of dementia or MCI were included. ⋯ All subjects were without dementia or MCI at baseline. The quantitative meta-analysis showed that subjects with diabetes had higher risk for AD (relative risk (RR):1.46, 95% confidence interval (CI): 1.20-1.77), VD (RR: 2.48, 95% CI: 2.08-2.96), any dementia (RR: 1.51, 95% CI: 1.31-1.74) and MCI (RR: 1.21, 95% CI: 1.02-1.45) than those without. The quantitative meta-analysis showed that diabetes was a risk factor for incident dementia (including AD, VD and any dementia) and MCI.
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Internal medicine journal · May 2012
Multicenter StudyCurrent discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative.
Evidence-practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. ⋯ The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of patients with ACS.