Internal medicine journal
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Internal medicine journal · Jun 2021
ReviewThe Australian burden of invasive group A streptococcal disease - a narrative review.
The Australian and New Zealand governments have allocated significant funding to advance efforts towards a group A Streptococcus (Strep A) vaccine. The argument for Strep A vaccine development has to date focussed on prevention of non-invasive disease (e.g. pharyngitis) and immune-mediated complications (especially rheumatic heart disease). Because of the poorer prognosis and theoretically more precisely known burden of invasive, compared to non-invasive disease, exploration of the burden of invasive Strep A disease could lend further support to the vaccine business case. ⋯ Preventing invasive Strep A disease is an important use for a Strep A vaccine. This narrative review highlights deficiencies in our current understanding of the Australian disease burden. These difficulties would be overcome by nationally consistent mandatory case reporting.
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Internal medicine journal · Jun 2021
Outcomes of Diabetic Ketoacidosis in a Tertiary Center with Restricted ICU Bed Capacity.
Diabetic ketoacidosis (DKA) is an acute metabolic condition, sometimes requiring admission to an intensive care unit (ICU). ⋯ In a setting of limited ICU capacity, DKA treatment does not necessarily require admission to the ICU. When the rising rates of diabetes mellitus and the associated elevated rates of DKA are taken into account, our results highlight the importance of including step-down units when devising local protocols for care of these patients.
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Internal medicine journal · Jun 2021
Osteopontin, GLUT1 and Ki67 expression in malignant peritoneal mesothelioma: Prognostic implications.
Malignant peritoneal mesothelioma is the most common primary peritoneal neoplasm. The only universally recognised pathological prognostic factor is histopathological subtype. Prognostic markers based on patient features and clinical stages have been disappointing. ⋯ OPN, Ki-67, treatment and PCI were independent indicators for OS, and a higher level of OPN expression correlated significantly with poorer OS.
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Internal medicine journal · Jun 2021
Abrupt change to telephone follow-up clinics in a regional rheumatology service during COVID-19: analysis of treatment decisions.
During the 2020 COVID-19 lockdown our rheumatology service provided follow up by phone. We reviewed clinic documents to compare patients serviced, and patient assessment and treatment outcomes. More patients received care during the lockdown but patient rheumatic disease was deemed active less frequently, more patients had no change to disease-modifying anti-rheumatic drugs and patients were less likely to have an intervention arranged. This suggests careful patient selection and appropriate infrastructure should be part of future rheumatology telemedicine.
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Historical writings of the growth of the Colony at Sydney Cove, Warrane, offered limited insight into the deprivations endured by sufferers of the 18th century canker, lues venerea, syphilis. Despite Governor Arthur Phillip's well-meaning precautions, the disease effortlessly accompanied the First Fleet, rapidly spread among the Colonial inhabitants and very soon spilled over to the indigenous Cadigal clansmen. Sporadic reporting by early Sydney diarists delineated the unstoppable course of the advancing affliction.