Internal medicine journal
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Internal medicine journal · Feb 2024
The utility of rested prolactin sampling in the evaluation of hyperprolactinaemia.
Serum prolactin levels may be elevated by venepuncture stress. We investigated the utility of a rested prolactin sample, obtained through an indwelling venous cannula, in preventing the overdiagnosis of hyperprolactinaemia. ⋯ Serum prolactin results are frequently elevated by the stress of venepuncture. Confirmation of pathological hyperprolactinaemia in a rested sample obtained from an indwelling venous cannula is recommended in patients with mild hyperprolactinaemia, particularly when the referral prolactin is less than two times the URL.
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Internal medicine journal · Feb 2024
Observational StudyThe lingering symptoms of post-COVID-19 condition (long-COVID): a prospective cohort study.
Longer-term symptoms (long COVID) may be present in seemingly recovered patients for several months and can be debilitating. ⋯ Long-term COVID-19 symptoms exist among recovered patients up to 12 months after contracting the virus. Fatigue is a primary contributor, while chronic pain became more problematic after 6 months. Vaccination was a factor in preventing long-term symptoms and aiding faster recovery from symptoms. Further work exploring additional contributors to symptom prevalence would assist in developing appropriate follow-up care.
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Internal medicine journal · Feb 2024
Beyond the aspirational: Creating the future of health care in Australia.
The context of health care in Australia is shifting very rapidly; more chronic diseases, budgetary stress and the constant threat of the next pandemic and climate change mean that patterns of disease and care are changing, and the workforce is under pressure. Health systems have learned to respond as best they can, but there are many challenges and opportunities for the Australian health care system to plan and implement an evidence-based and sustainable approach to health care delivery in the next decade. ⋯ Here, we outline nine strategies that span principles of integrated, value-based care, with a focus on prevention and quality, the development of a skilled workforce and health-literate population and the use of emerging technologies such as genomics and artificial intelligence. These strategies form a potential path for the Australian health care system to meet the changing requirements of the current decade and take the aspirational visions of the future of health care into an improved, patient-based health system that delivers care in line with best practices.
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Internal medicine journal · Feb 2024
Oral antimicrobial therapy for cellulitis versus outpatient parenteral antimicrobial therapy: a single-centre audit of cellulitis outcomes.
Cellulitis is a common acute skin and soft tissue infection that causes substantial morbidity and healthcare costs. ⋯ Implementation of a change in outpatient cellulitis treatment pathway resulted in a significant change in prescribing practice. Our findings suggest that OBLT was both tolerable and had similar outcomes to OPAT.
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Internal medicine journal · Feb 2024
Clinician perceptions of research priorities for the management of noncritically ill patients admitted to hospital with SARS-CoV-2 infection.
The changing phenotype of coronarvirus disease 2019 (COVID-19) may quickly render guideline-recommended interventions obsolete. We developed a 40-question clinician survey in consultation with the Australasian COVID-19 Trial site investigators. The survey was designed to assess clinician perceptions of the current treatment strategies and future research priorities in the management of non-critically ill patients admitted to hospital with SARS-CoV-2 infection. ⋯ The perceived prevalence of patients with incidental COVID-19, nosocomial infection, underlying illness exacerbated by COVID-19, and/or immunocompromised status suggests new populations to target. The results highlighted clinician interest in antiviral therapies for future research in both immunocompetent and immunocompromised cohorts. These survey results underscore the need for ongoing surveillance of COVID-19 disease phenotypes and clinician and patient priorities for future research.