Internal medicine journal
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Internal medicine journal · Apr 2024
Hepatitis B genotypes in Aboriginal and Torres Strait Islander Australians: correlation with clinical course and implications for management.
The prevalence of chronic hepatitis B (CHB) in Aboriginal and Torres Strait Islander Australians in Far North Queensland (FNQ) is greater than twice that of the general Australian population. CHB is common in Torres Strait Islanders diagnosed with hepatocellular carcinoma (HCC) - and in Aboriginals with HCC living in the Northern Territory - however, Aboriginals diagnosed with HCC in FNQ very rarely have CHB. The explanation for this apparent disparity is uncertain. ⋯ HBV genotypes in Aboriginal and Torres Strait Islander Australians in FNQ differ markedly, which could explain the significant differences in the clinical phenotype in the two populations and might be used to inform cost-effective CHB care in the region.
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Internal medicine journal · Apr 2024
Observational StudyEvaluation of a virtual ward model of care and readmission characteristics during the COVID-19 pandemic within an Australian tertiary hospital.
Virtual ward (VW) models of care established during the coronavirus disease 2019 (COVID-19) pandemic provided safe and equitable provision of ambulatory care for low-risk patients; however, little is known about patients who require escalation of care to hospitals from VWs. ⋯ This VW model of care was both safe and effective when applied to a broad socioeconomic population during the COVID-19 pandemic. While readmission to the hospital was low, this study identified key characteristics of such presentations, which may assist future triaging, escalation and resource allocation within VWs during the COVID-19 pandemic and beyond.
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Internal medicine journal · Apr 2024
Incidental central pulmonary emboli in outpatients with deep vein thrombosis.
While it has been demonstrated that large asymptomatic pulmonary embolism (PE) can occur, many studies have assessed inpatients or patients with known risk factors for venous thromboembolism (such as malignancy). There are few data regarding incidental PE in outpatients with deep vein thrombosis (DVT) or assessing whether these emboli occur centrally or peripherally in the pulmonary arteries. ⋯ Incidental PE occur frequently in outpatients with lower limb DVT, including the possibility of asymptomatic central emboli. Further studies with larger patient cohorts would be useful to assess the utility of baseline chest imaging in outpatients with DVT.
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Internal medicine journal · Apr 2024
Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji.
Oxygen therapy (OT) is a commonly prescribed essential medicine for people of all ages in the management of hypoxia. The adverse effects of inappropriate OT supplementation may be underestimated by health professionals and lead to poor health outcomes among hospitalised patients. Knowledge, attitude and practice (KAP) assessments of medical staff members to OT guidelines are essential to ensure optimal patient care. ⋯ Good KAP scores were obtained for medical staff in Fiji regarding OT administration. Ongoing professional education activities should include updated training of OT contraindications and optimal oxygen saturation levels for special patient groups.
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Internal medicine journal · Apr 2024
Factors leading to diagnostic delay in tuberculosis in the tropical north of Australia.
Tuberculosis (TB) incidence is decreasing in the Northern Territory (NT) but still exceeds rates elsewhere in Australia. Deaths and morbidity from advanced TB continue, with delay in diagnosis a contributor to adverse outcomes. ⋯ The patient delays we report are longer than reported elsewhere in Australia. The next steps will require concerted efforts to improve community awareness of TB and strategies to strengthen health systems through better resourcing and healthcare provider support.