Internal medicine journal
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Internal medicine journal · Feb 2022
ReviewOral health and cardiometabolic disease: understanding the relationship.
Examination of the oral cavity can identify clinical signs indicative of underlying systemic disease. Key features to examine include the general appearance and number of the teeth, signs of inflammation of the mucosa or gingival tissues including bleeding of the gums and redness, swelling or hyperplasia. Additionally, the tongue should be assessed for any ulceration or discolouration and the presence of excessive build-up (coating). ⋯ Key features of periodontitis and xerostomia will be provided along with a brief discussion of current concepts in early prevention and management of these oral health conditions. The biological mechanisms linking cardiometabolic disease and periodontitis will be outlined and the evidence supporting the association between cardiometabolic disease and oral health conditions will be presented together with an identification of areas where further research is indicated. Last, guidance for general practitioners to assess and support early diagnosis and management of oral health conditions by raising awareness of the relationship between oral health and cardiometabolic disease, providing simple oral health advice and referring to a dental practitioner will be presented.
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Internal medicine journal · Feb 2022
Proposed empiric antibiotic therapy for prosthetic joint infections: an analysis of the Prosthetic Joint Infection in Australia and New Zealand, Observational (PIANO) cohort.
Empiric antibiotic therapy in suspected prosthetic joint infection should cover likely pathogens while avoiding overly broad-spectrum antibiotics. We analysed individual patient data from a large prospective cohort study (Prosthetic Joint Infection in Australia and New Zealand, Observational (PIANO)) and found that causative organisms vary with the presentation type, with early post-operative infections more likely to be polymicrobial (41%) compared with late acute infections (10%). We thus propose empirical regimens tailored to the presentation type and presence or absence of sepsis.
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Internal medicine journal · Feb 2022
Prospective Study of Policies and Use of Therapies for COVID-19 Amongst Australian Health Services during 2020.
The COVID-19 pandemic has generated significant debate about how emerging infections can be treated in the absence of evidence-based therapies to combat disease. In particular, the use of off-label therapies outside of a clinical trial setting has been controversial. ⋯ Our results reflect the reactive nature of prescribing of therapies for COVID-19 and highlight the importance of evidence-based guidelines to assist prescribers.
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Internal medicine journal · Feb 2022
Hospitalisation and associated costs of gastrointestinal bleeding from primary prevention aspirin use in South Australia: a retrospective case series analysis.
We assessed hospitalisations for gastrointestinal bleeding directly related to primary prevention aspirin in lower risk patients for a 6-month period in three South Australian hospitals. Those with related underlying pathology or concurrent causative medication were excluded. ⋯ Mean hospital admission cost was $6769 (95% confidence interval $5198-$8340), with projected state and national annual costs of $0.57 and $8.12 million respectively. In light of recent guideline changes, clinicians need to vigorously assess the need for primary prevention aspirin.
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Internal medicine journal · Feb 2022
Automated information extraction from free-text medical documents for stroke key performance indicators: a pilot study.
Automated information extraction might be able to assist with the collection of stroke key performance indicators (KPI). The feasibility of using natural language processing for classification-based KPI and datetime field extraction was assessed. ⋯ The datetime field extraction method was successful in 29 of 43 (67.4%) cases. Further studies are indicated.