Internal medicine journal
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Internal medicine journal · Nov 2022
The first Australian experience with ward-based CPAP for COVID19 respiratory failure: A retrospective cohort study.
We present the first Australian cohort of patients with COVID-19 respiratory failure managed with escalating respiratory support including continuous positive airway pressure (CPAP) on a standard medical ward at a tertiary Sydney hospital during the 2021 COVID-19 Delta variant outbreak. We demonstrate an equivalent mortality to CPAP delivered in intensive care unit and outline our ward structure and management during the pandemic.
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Internal medicine journal · Nov 2022
Insulin sensitivity, cardiovascular function and bone health in women with early stage breast cancer before and after cancer treatment.
Cardiovascular disease is a leading cause of death in breast cancer survivors, but the underlying cause is not fully characterised. ⋯ Patients with breast cancer had higher triglycerides before treatment and a reduction in insulin sensitivity and bone mass following cancer treatment. Future larger and longer-term studies should characterise the effect of reduced insulin sensitivity on rates of diabetes, cardiovascular disease, cancer outcomes and fracture.
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Internal medicine journal · Nov 2022
Nudix Hydrolase 15 loss-of-function variants in an Australian Inflammatory Bowel Disease population.
Thiopurine-related adverse events such as leukopenia, liver dysfunction and pancreatitis are associated with variants in the NUDT15 gene. Loss-of-function (low or no enzyme activity) alleles are more common in Asian and Hispanic populations. The prevalence of these variants in the Australian inflammatory bowel disease (IBD) population has not yet been reported. ⋯ This is the first study to report the frequency of NUDT15 haplotypes *2,*3,*9 in an Australian IBD population. The most common variant detected was the R139C mutation. PCR and Sanger sequencing are efficient and cost-effective approaches for NUDT15 genotyping.
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Internal medicine journal · Nov 2022
The short-term outcomes of patients with chronic liver disease hospitalized with COVID-19.
Patients with chronic liver disease (CLD) might have an aggravated course after acquisition of coronavirus disease 2019 (COVID-19). ⋯ Cirrhosis is independently associated with higher 30-day mortality of hospitalised patients with COVID-19.
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Internal medicine journal · Nov 2022
COVID vaccination can be performed in patients with a history of allergic reactions to the vaccines or their components: experience from a specialist clinic in South Australia.
The development of vaccines against SARS-CoV2 has been a key public health response to the COVID-19 pandemic. However, since their introduction, there have been reports of anaphylactic reactions to vaccines in individuals with history of allergic reactions to other vaccines, excipients or to COVID vaccines. ⋯ Even in a high-risk population, most patients can be vaccinated with available COVID-19 vaccines. This paper reports local experiences using a combined allergy testing protocol with skin testing and BAT during the pandemic.