Internal medicine journal
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Internal medicine journal · Aug 2019
Frailty is associated with reduced prospect of discharge home after in-hospital cardiac arrest.
Frailty is common among acute hospital patients and might adversely affect recovery from inpatient cardiac arrest. ⋯ Frail patients are unlikely to make a good recovery after in-hospital arrest. This should be taken into account when planning care with patients and their families.
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The visit to Australia by Dr David Pencheon, Founding Director of the National Health Service (NHS) Sustainable Development Unit, in April-May 2018 generated considerable interest and engagement. Dr Pencheon's overarching messages were that climate change is a health issue and that doctors and health systems have an opportunity, and responsibility, to lead climate action. ⋯ For each theme, we highlight promising initiatives that are already underway in Australia that are starting to transform our health system into one fit for a future environmentally sustainable world. We suggest practical ways in which doctors can lead the transformation through personal action and influence broader systems.
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Internal medicine journal · Aug 2019
Introduction of portable bedside echocardiography to acute general medicine.
We reviewed the medical records of all patients who underwent portable bedside echocardiography under general medicine over a 15-month period. The mean age of patients was 67 years (range 16-95) (n = 201). Indications for scanning included syncope (27%), murmur (17%) and dyspnoea (14%); findings included valve abnormalities (46%), left ventricular hypertrophy (26%) and dilated left ventricle (15%). Bedside echocardiography is a useful extension of the physical examination but is operator-dependent, and its routine use in general medicine will depend on the availability of training, group reporting sessions and quality assurance.