Internal medicine journal
-
Internal medicine journal · Jul 2021
ReviewEndocrine adverse effects of immune checkpoint inhibitors.
Immune checkpoint inhibitors are increasingly being utilised as an effective therapy for a variety of cancers. However, they have the potential to cause serious autoimmune toxicities in multiple organ systems termed 'immunotherapy-related adverse events'. ⋯ This makes it important for all physicians, in addition to endocrinologists and oncologists, to understand the nature of these reactions and the general approach to their diagnosis and management. This review aims to provide an overview of the epidemiology, pathophysiology, clinical presentation and management of the endocrine adverse events.
-
Internal medicine journal · Jul 2021
Utility of "back-up" arterio-venous fistulae in patients on peritoneal dialysis and use of haemodialysis catheters.
Patients undergoing peritoneal dialysis may require unanticipated transfer to haemodialysis. Back up fistula are often created in selected patients. These may help reduce the infective burden of haemodialysis (HD) catheter. ⋯ Patients undergoing PD frequently require urgent unanticipated transfer to HD and back-up AVF can be successfully utilised in this setting in the majority of cases, which in turn can reduce the infective burden of HD catheter exposure.
-
Internal medicine journal · Jul 2021
EVALUATION OF CALLING CRITERIA FOR THE RAPID RESPONSE SYSTEM UTILISING SINGLE VERSUS MULTIPLE PHYSIOLOGICAL PARAMETER DISTURBANCES.
The Adult Deterioration Detection System for Medical Emergency Team (MET) activation is widely used and includes single parameter (SP-MET) and multiple parameter (MP-MET) disturbances. Whether the patient characteristics, interventions and outcomes differ for SP-MET compared with MP-MET is uncertain. ⋯ SP-MET identify a cohort of patients at lower risk of requiring escalation of care and ICU admission. Given the resource intensity of MET activation, further research is warranted to determine whether alternative response strategies are appropriate for selected SP disturbances.
-
Internal medicine journal · Jul 2021
The application of Telehealth to remote and rural Australians with chronic neurological conditions.
Patients with chronic disease in rural and remote regions endure limited access to specialised medicine. Telehealth has addressed this issue with demonstrable benefits such as a reduction in costs to patients. ⋯ Telehealth has proven to have multiple advantages, including improved access to healthcare, decreased costs, reduced inconvenience and improved management of chronic and complex conditions. The positive results advocate the use of telehealth for follow up of rural and remote patients with chronic disease.