Internal medicine journal
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Internal medicine journal · Dec 2021
Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: A cross-sectional survey.
A resuscitation plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances. ⋯ Most junior doctors feel confident discussing and documenting resuscitation plans. There is a need to improve knowledge about legal obligations to follow completed resuscitation plans, and about when resuscitation plans should be completed to ensure they are completed with patients who are most at risk.
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Internal medicine journal · Dec 2021
No effect of sleeved arms on the accuracy of blood pressure measurement.
It is recommended that blood pressure should be measured on a bare upper arm with an appropriately sized cuff. However, in practice, it is more convenient to measure blood pressure on sleeved arms. ⋯ In the present study, we concluded that there was no significant effect of sleeved arms on the accuracy of blood pressure measurement by using an electronic oscillometric sphygmomanometer equipped with a conventional cuff.
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Internal medicine journal · Dec 2021
Discussion of Advance Care Planning on end of life decisions with lung cancer patients in Wuhan China: Attitude, Timing, and Future Directions.
Progress in advance care planning (ACP) in China has been hindered for decades compared with other countries. ⋯ Chinese patients showed preferences towards ACP, but with inadequate knowledge. More assistance is needed with ACP for those patients, especially for females, patients with one child and those with early stage lung cancer. For female patients and patients receiving treatment, doctors may initiate ACP dialogue first.
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Internal medicine journal · Dec 2021
Invasive pulmonary aspergillosis in critically ill patients with COVID-19 in Australia: implications for screening and treatment.
We report four cases of invasive pulmonary aspergillus co-infection in patients with coronavirus disease 2019 (COVID-19) infection and acute respiratory distress syndrome requiring intensive care unit (ICU) admission. Aspergillus fumigatus and Aspergillus terreus were isolated, with early infection onset following ICU admission. ⋯ We propose screening of these high-risk patients with twice-weekly fungal culture from tracheal aspirate and, if feasible, Aspergillus polymerase chain reaction. Diagnosis is challenging and antifungal treatment should be considered in critically ill patients who have new or worsening pulmonary changes on chest imaging and mycological evidence of infection.
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Internal medicine journal · Dec 2021
Acromegaly Might Not Negatively Affect Microvascular Circulation.
Endothelial dysfunction and atherosclerosis are well known complications of acromegaly. However, current data on microvascular circulation are limited. ⋯ Although the number of capillaries was statistically lower in patients with acromegaly, they were within a normal range and the difference was not clinically significant. Moreover, there was no difference in morphological characteristics between the groups. While endothelial dysfunction is the earliest known marker of the atherosclerotic process and is considered to be one of the complications of acromegaly, the disease may not result in impairment of microvasculature of those people afflicted by it.