Internal medicine journal
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Internal medicine journal · Dec 2022
Antenatal FibroScan® assessment for metabolic associated fatty liver in pregnant women at risk of gestational diabetes from a multiethnic population - a pilot study.
Metabolic-associated fatty liver disease (MAFLD) is a leading cause of chronic liver disease with increasingly recognised associations with gestational diabetes (GDM), including within the antenatal period. ⋯ There was no statistically significant association between FibroScan®-detected MAFLD in early pregnancy and subsequent development of GDM in this pilot study. Maternal weight gain may be associated with changes in the CAP scores, which reflect steatosis, during pregnancy.
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Internal medicine journal · Dec 2022
Outcomes following parathyroidectomy for secondary hyperparathyroidism in patients with chronic kidney disease - a single-centre study.
Surgical parathyroidectomy may be required for severe and refractory secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD). Parathyroidectomy is associated with long-term survival benefit despite an increase in short-term morbidity and mortality. Global variation in practice exists, with limited Australian data on outcomes following parathyroidectomy. ⋯ Significant fluctuations in serum calcium levels are common post-parathyroidectomy; however, long-term morbidity and mortality in our cohort were lower than previously reported, highlighting that parathyroidectomy in a carefully selected cohort is safe for severe SHPT refractory to medical treatment.
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Internal medicine journal · Dec 2022
Diagnostic challenges for dementia in Australia: are blood-based biomarkers the solution?
The burden of dementia will increase as the Australian population ages and grows in coming decades. Early and accurate diagnosis remains challenging, and disproportionately so for particular groups, including rural communities. Recent advances in technology, however, now allow reliable measurement of blood biomarkers that could improve diagnosis in a range of settings. We discuss the most promising biomarker candidates for translation into clinical practice and research in the near future.
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Internal medicine journal · Dec 2022
Observational StudyRegistrar Triage, Communication and Moral Distress during End of Life Care Rapid Response Team Calls in a Teaching Hospital.
Approximately one-third of rapid response teams (RRT) involve end-of-life care (EOLC) issues. Intensive care unit (ICU) registrar experience in such calls is underinvestigated. ⋯ EOLC issues occur commonly in RRT calls and are often associated with moral distress to ICU registrars. Although consensus on prognostication is usually achieved, conversations often involve covering doctors. These issues impact on the ICU registrar experience of RRT calls and require further exploration.