Internal medicine journal
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Internal medicine journal · Oct 2024
Impact of Karnofsky performance status on outcomes of patients with severe alcohol-associated hepatitis: a propensity-matched analysis.
Severity scores, including the model for end-stage liver disease (MELD) and discriminant function score, guide the treatment of patients with severe alcohol-associated hepatitis (AH). We aimed to investigate the impact of functional status on outcomes of patients with AH. ⋯ KPS is an important determinant of outcomes in patients with AH, including survival, recompensation, response to corticosteroids and complications.
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Internal medicine journal · Oct 2024
Predictive value of urine microscopy and urine culture in bacteraemic adults without localising urinary features.
Urine microscopy (UM) and urine culture (UC) are used in bacteraemic patients to identify a urinary focus of infection. However, their positive and negative predictive values (PPV and NPV) in patients without localising urinary features are uncertain. ⋯ bUTI without localising urinary features is common. In bacteraemia of unclear focus, UM/UC has a high NPV for excluding bUTI, although PPV is limited and non-urinary foci require consideration despite a positive result. UM/UC is low yield in those with a suspected non-urinary focus of infection.
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Granulomatous amoebic encephalitis is a rare but likely under-recognised form of subacute, usually fatal, encephalitis. We present an illustrative case report and literature review of Australian cases, summarising clinical features, diagnostic methods, treatment and outcomes.
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Shoulder weakness with unilateral scapular winging is a common issue that initially presents to the general physician, sports physician or rheumatologist. Although most of these cases are neurogenic in nature, it is important to consider alternative causes for unilateral scapular winging. Muscular dystrophies can present with marked asymmetry, the most typical being facioscapulohumeral dystrophy (FSHD). We describe a case of FSHD with a summary of the key clinical features to increase the awareness of this condition among physicians.
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Internal medicine journal · Oct 2024
A national study of infective endocarditis models of care in Australia.
Multidisciplinary endocarditis team (MDET) management is supported by current evidence and recommended in international society guidelines. The extent to which this recommendation has been implemented in Australian centres and the attitudes, barriers and facilitators of this model are unclear. ⋯ Even though it is recommended in international guidelines, the MDET model is used by less than one-third of Australian specialist referral centres. Stakeholders in IE care have generally favourable attitudes towards MDET implementation but cite a lack of resources, funding, collaboration and time as barriers to this. Dedication of financial and administrative support and leadership from key stakeholders are required to increase MDET utilisation.