Internal medicine journal
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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.
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Internal medicine journal · Oct 2019
Behaviour change techniques to optimise participation in physical activity or exercise in adolescents and young adults with chronic cardiorespiratory conditions: a systematic review.
Participation in regular physical activity decreases the risk of developing cardiometabolic disease. However, the proportion of people who participate in the recommended amount of physical activity is low, with common barriers including competing interests and inclement weather. In people with chronic cardiorespiratory conditions, participation in physical activity is reduced further by disease-specific barriers, time burden of treatment and unpleasant symptoms during physical activity. ⋯ The most commonly used BCT comprised goal setting, action planning and social support. Five BCT were solely used in 'promising' interventions. Our review demonstrated that only 20% of BCT have been utilised, and those BCT that were used only in 'promising' physical activity interventions in adolescents and adults with chronic cardiorespiratory conditions were isolated.
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Internal medicine journal · Oct 2019
Idarucizumab for dabigatran reversal: the first 6 months in a tertiary centre.
This retrospective audit reviews patients on dabigatran presenting with bleeding or requiring urgent surgery in the Wellington region, whether they received idarucizumab appropriately and the outcome of episodes. Eighty patients were identified with bleeding or need for urgent surgery, 14 of which received idarucizumab. ⋯ Idarucizumab was underutilised with patients who could have benefited not receiving it; however, some patients who were treated may not have required it. Increased awareness and use may improve outcomes.
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Internal medicine journal · Oct 2019
Analysis of patients referred for aged care assessment with concerns related to hoarding or squalor.
Patients referred with concerns related to hoarding and squalor frequently pose significant management challenges. We conducted a retrospective analysis of 120 patients referred to an Aged Care Assessment Service. ⋯ Mild cognitive impairment was the most common cognitive diagnosis, no cognitive diagnosis was made in 25% and the usual diagnostic process could not be followed in 13%. This analysis provides relevant Australian specific data to assist with planning service delivery for a group of patients with complex management issues.