Internal medicine journal
-
Internal medicine journal · Sep 2019
Recommendations for current and future countermeasures against sleep disorders and sleep loss to improve road safety in Australia.
The Australian National Road Safety Strategy 2011-2020 framed a 19-point action plan targeting a 30% reduction in road deaths by 2020. In achieving a 9% reduction to date, it is likely to fail this target. ⋯ This article gathers sleep experts to provide recommendations addressing driver education and legislation to assist the response to this public health problem. Developments in drowsiness detection and sleep disorders management are also presented that offer innovative countermeasures that could enhance road safety beyond 2020.
-
Interval laboratory investigations are necessary for monitoring chronic diseases. However, testing too frequently may not be beneficial clinically and can be considered low-value care. We examined the frequency of glycosylated haemoglobin, lipids, iron panels (serum iron, ferritin, transferrin, iron binding) thyroid function (free T4 and thyroid stimulating hormone) and 25-OH vitamin D tests in a 1290-bed tertiary hospital in Singapore. ⋯ Of the 275 565 tests done for 115 971 patients, 5.2% were repeat tests done at intervals shorter than the minimum retesting interval, as defined by the Royal College of Pathologist and Irish Guidelines on the Use of the Laboratory. Using the Centers for Medicare and Medicaid Services Clinical Laboratory Fee Schedule, we estimated a cost burden of US$222 096 per year. Strategies to reduce unnecessary repetitive testing can result in significant cost savings.
-
Internal medicine journal · Sep 2019
Letter Case ReportsScurvy: a rare cause of arthralgia in a young woman.
-
Internal medicine journal · Sep 2019
Case ReportsLeukocytoclastic vasculitis associated with use of aromatase inhibitors.
Leukocytoclastic vasculitis is an uncommon but important complication of aromatase inhibitor use which may have cosmetic and systemic ramifications. We present a case in which this reaction was observed and aim to compare the characteristics of patients and trajectory of disease in order to assist with early identification and treatment.
-
Internal medicine journal · Sep 2019
Assessment, incidence and factors associated with urinary incontinence in older Aboriginal Australians.
Little is known about urinary incontinence in older Aboriginal Australians. ⋯ The prevalence and incidence of urinary incontinence in Aboriginal Australians is high with risk factors of older age and female sex. The modified ICIQ and self-report appear to be appropriate incontinence screens. Further research to understand causes and treatments within this population is urgently required.