Internal medicine journal
-
Internal medicine journal · Nov 2018
Diagnostic yield of pleural fluid cytology in malignant effusions: an Australian tertiary centre experience.
Timely diagnosis of malignant pleural effusions is critical to guide prognosis and management decisions. Cytological analysis of pleural fluid has been the first-line diagnostic test for many decades, with highly variable reported sensitivities of 40-90%. Its diagnostic accuracy in modern practice in Australia needs to be understood. ⋯ Tumour type is an important determinant of pleural fluid cytology diagnostic yield. Cytology has good sensitivity and specificity for the diagnosis of adenocarcinoma, but if another tumour type is suspected, particularly mesothelioma, clinicians should be aware of the limitations.
-
Internal medicine journal · Nov 2018
Comparative StudyEvaluation of chronic kidney disease in cancer patients: is there a preferred estimation formula?
The evaluation of chronic kidney disease (CKD) in cancer patients seems to rely mostly on the Cockcroft-Gault (CG) formula or the creatinine levels to adjust treatment dosages which is a practice refuted by internists. ⋯ The newly proposed JW eGFR estimation was more in agreement with CG equation than the other equations.
-
Internal medicine journal · Nov 2018
Characteristics of patients who progress from bridging to long-term oxygen therapy.
Patients with persistent hypoxia following an acute hospital admission may be discharged with 'bridging' domiciliary oxygen as per criteria defined by the Thoracic Society of Australia and New Zealand. The need for continuous long-term oxygen therapy (LTOT) is then reassessed at a clinic review 1-2 months later. ⋯ PaO2 at time of discharge provides a signal with the potential to identify who will require continuous LTOT following an acute hospital admission. Additionally, this study highlights the need to re-evaluate patients' oxygen requirements during a period of clinical stability.