Internal medicine journal
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Internal medicine journal · Jul 2020
ReviewPractical management of inflammatory bowel disease patients during the COVID-19 pandemic: expert commentary from the Gastroenterological Society of Australia Inflammatory Bowel Disease faculty.
The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.
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Internal medicine journal · Jul 2020
ReviewOptimising the response to acute clinical deterioration: the role of observation and response charts.
We sought the role of the hospital inpatient observation and response chart (ORC) in reducing adverse outcomes. We sourced articles written in English and published in PubMed. Track, trigger and response systems can be tiered and use single parameter or aggregate scoring systems; the latter being more prone to error. ⋯ Detecting and responding to deteriorating patients relies upon accurate and clear documentation of vital signs. ORC design and staff education on ORC implementation and usage are integral to minimising ALF and optimising patient outcomes. Standardisation of the design of both the ORC and the hospital RRS are overdue.
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Internal medicine journal · Jul 2020
Meta AnalysisIncident atrial fibrillation in patients undergoing bariatric surgery: a systematic review and meta-analysis.
There are controversial data regarding the relationship between bariatric surgery and atrial fibrillation (AF). This meta-analysis was performed to evaluate (i) the incidence and (ii) the risk of AF in patients following bariatric surgery. ⋯ The overall estimated incidence of AF following bariatric surgery was 5.3%. Our study demonstrates a significant beneficial association between bariatric surgery and AF, with a 0.42-fold decreased risk of AF. Future large-scale studies are needed to confirm the potential benefits of bariatric surgery on risk of AF.
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Internal medicine journal · Jul 2020
Contemporary trends in stroke complicating cardiac catheterisation.
Stroke remains an important complication of diagnostic cardiac catheterisation and percutaneous coronary intervention and is associated with high rates of in-hospital mortality. ⋯ The incidence and functional severity of stroke remains low despite evolving procedural practice with a stable incidence over time despite changes in procedural practice; however, post-procedural stroke confirms an increased mortality hazard.
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Internal medicine journal · Jul 2020
Observational StudyShort-term colectomy is avoided in over half of regional patients failing medical therapy for acute severe ulcerative colitis with co-ordinated transfer and tertiary care.
Many patients presenting with an acute severe ulcerative colitis to a regional hospital are transferred to a metropolitan hospital for specialised care. This study aimed to evaluate the outcomes and characteristics of these patients. ⋯ Over 50% of the patients failing therapy in a regional centre and requiring transfer avoided short term colectomy with co-ordinated referral for rescue therapy in a tertiary metropolitan inflammatory bowel disease unit. These patients would have ultimately required colectomy in their regional hospital without intervention.