Internal medicine journal
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Internal medicine journal · Oct 2019
Review Practice GuidelineDiagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases.
Candida auris is an emerging drug-resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). ⋯ Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination.
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Internal medicine journal · Oct 2019
Results of a survey of cancer patients' willingness to travel to participate in a clinical trial.
Only 2-3% of cancer patients enrol in a trial. We surveyed patients' willingness to change clinician or treating centre, or to travel, to participate in trials, to improve trial recruitment. ⋯ Rural and regional patients, and those from lower socio-economic areas, were more willing to travel. To optimise access to trials, clinicians should refer within and between institutions.
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Internal medicine journal · Oct 2019
Elevated D-dimer levels predict adverse outcomes in hospitalised elderly patients with chronic heart failure.
Elevated D-dimer levels have been associated with poor outcomes in patients with cardiovascular disease. ⋯ In elderly patients with CHF, measurement of D-dimer levels may help to risk stratify these patients, and high D-dimer levels might be regarded as a warning sign to intensify therapy.
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Internal medicine journal · Oct 2019
Impact of universal immunohistochemistry on Lynch syndrome diagnosis in an Australian colorectal cancer cohort.
Current guidelines recommend a step-wise screening algorithm for all colorectal carcinomas (CRC) to identify patients with Lynch syndrome (LS). ⋯ Universal IHC testing may increase the detection of LS, and should be implemented where possible. However, the full benefit was limited by low referral to and uptake of genetic testing, and further strategies are needed to overcome these barriers.