Internal medicine journal
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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
Illicit drug use and acute kidney injury in patients admitted to hospital with rhabdomyolysis.
Severe rhabdomyolysis is associated with acute kidney injury, but it is unclear if patients developing rhabdomyolysis after illicit drug use have a higher risk of acute kidney injury compared to other causes. ⋯ Illicit drug use was associated with acute kidney injury and renal replacement therapy independent of creatine kinase levels.
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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
Evaluating a risk assessment tool to improve triaging of patients to colonoscopies.
Colonoscopy is the gold standard in the diagnosis of significant bowel disease (SBD), including colorectal cancer, high-risk adenoma and inflammatory bowel disease. As the demand for colonoscopy services is placing significant pressure on hospital resources, new solutions are needed to manage patients more efficiently and effectively. ⋯ A hybrid model that combines patient-level characteristics with hospital-level resource constraints can demonstrate improved efficiency in a hospital clinic. Further research on risk assessment is required to improve quality patient care and reduce low-value service delivery.
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Internal medicine journal · Oct 2019
Observational StudyResource use and outcomes in patients with dialysis-dependent chronic kidney disease admitted to intensive care.
Central Australia (CA) has a high prevalence of haemodialysis-dependent chronic kidney disease (CKD5D). CKD5D is associated with an increased need for critical care services. ⋯ This retrospective observational matched cohort study examining the burden of disease amongst CKD5D patients in CA suggests that there is no additional mortality burden in this group, nor do they require significantly higher critical care resources compared to a matched cohort.