Internal medicine journal
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Internal medicine journal · Apr 2023
Danger in discharge summaries: Abbreviations create confusion for both author and recipient.
The transition from hospital inpatient care to medical care in the community is a high-risk period for adverse events. Inadequate communication, including low-quality or unavailable discharge summaries, has been shown to impact patient care. ⋯ Abbreviations are often used in discharge summaries, yet poorly understood. This has the potential to impact patient care in the transition period after hospitalisation.
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Internal medicine journal · Apr 2023
The basis and implications of diverging approaches to colorectal adenoma surveillance in the West.
Algorithms for the surveillance of colorectal adenomas have recently undergone revision in Australia and abroad. Despite a shared evidence base, significant differences are observed and optimal intervals for surveillance remain controversial. We sought to explore their differences in relation to current evidence, practical aspects and how we may improve our own approach to adenoma surveillance in Australia.
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Internal medicine journal · Apr 2023
Prevalence and correlates of advance care planning among Australian hospital inpatients.
The prevalence and factors associated with advance care planning (ACP) documents for Australian public hospital inpatients were determined through cross-sectional study of 123 Victorian hospitals between July 2016 and December 2018. Of the 611 786 included patients, 2.9% had an ACP document. Odds increased significantly in those comorbid, unpartnered, regional and >5 admissions, which supports future ACP conversations and document creation.
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Internal medicine journal · Apr 2023
Analysing Monday discharges to identify lost opportunities for weekend discharge.
Lower rates of hospital discharge occur on weekends compared with weekdays. The authors performed a retrospective chart review of Monday discharges from the Hospital Medicine service at an academic hospital over a 3-month period to identify reasons for delayed discharge despite medical stability. Of 202 eligible patients, 81 (40%) had documentation indicating stability for earlier discharge. Common causes included bed availability or insurance authorisation at a skilled nursing facility, home care services and patient/family disagreement with discharge.
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Internal medicine journal · Apr 2023
Low-dose thioguanine guided by therapeutic drug monitoring is a safe and effective alternative in inflammatory bowel disease patients intolerant to conventional thiopurines.
Thioguanine is an alternative thiopurine for inflammatory bowel disease (IBD) patients. ⋯ Thioguanine was tolerated well in 63% of patients. A clinical response was seen in 62% of patients, and maintenance of remission was high at 76%. No cases of early NRH were seen. Longer-term follow up is required to ensure safety and to assess durability of response.