Internal medicine journal
-
Sleep disturbance during menopause is a common and important complaint faced by many women. There are many factors that may play a role in this problem, including vasomotor symptoms and changing hormone levels, circadian rhythm abnormalities, exacerbation of primary insomnia, mood disorders, coexistent medical conditions as well as lifestyle factors. Sleep can be measured both objectively and subjectively; however, correlation between the two measures is not high. ⋯ This discrepancy has implications with regard to evaluation of research in sleep and menopause, as well as application in the clinical setting. Investigations of inadequate sleep and sleep problems during the menopausal period and obtaining a thorough understanding of the factors contributing to these problems are essential in formulating treatment strategies. Such strategies can vary from hormonal treatment and medications to lifestyle and behavioural modification.
-
Internal medicine journal · Jul 2012
Multicenter StudyQuality of life: a potentially useful measure to indicate subclinical flares in Crohn disease.
While quality of life (QoL) is a well-recognised outcome measure of Crohn disease (CD) activity, its influence on other outcome measures, including exacerbation of CD is poorly understood. If QoL measures were to be associated with intestinal inflammatory activity, they might be useful for early detection of subclinical flares. ⋯ The close association between QoL and subsequent flares suggests that QoL measures might be useful in detecting upcoming flares before they become clinically apparent.
-
Internal medicine journal · Jul 2012
Performance of comorbidity indices in measuring outcomes after acute myocardial infarction in Australian indigenous and non-indigenous patients.
Indigenous Australians have higher prevalence of chronic diseases and worse acute care outcomes than other Australians. The extent to which higher chronic disease comorbidity levels are responsible for their worse outcomes is not clear, and the performance of comorbidity indices has not been assessed for this population with very high comorbidity levels. ⋯ Comorbidity indices performed well in a population with very high chronic disease prevalence. After adjusting for comorbidity, short-term outcomes were similar for indigenous and non-indigenous AMI patients, but comorbidity at the time of the acute episode only partly explained the worse long-term outcomes for indigenous patients.
-
Internal medicine journal · Jul 2012
Review Meta AnalysisArterial stiffness as a cause of cognitive decline and dementia: a systematic review and meta-analysis.
Although arterial stiffness has recently been confirmed as a predictor of cardiovascular disease, the association between arterial stiffness and cognitive decline is less clear. ⋯ Aortic stiffness was found to predict cognitive decline in both qualitative review and quantitative analysis.
-
Internal medicine journal · Jul 2012
Intensive care unit experience of haemopoietic stem cell transplant patients.
Previous research at our institution (1988-1998) established an intensive care unit (ICU) and hospital mortality between 70% and 80% in haemopoietic stem cell transplant (HSCT) patients requiring ICU admission. ⋯ Our study found that acute admission of HSCT patients to the ICU is associated with improved survival compared to our previous experience, with organ failure progression a strong predictor of ICU outcome, and specific disease characteristics contributing to long-term survival.