Internal medicine journal
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Internal medicine journal · Feb 2025
The importance of assessing and correcting hydration status prior to right heart catheterisation: a pilot study.
We evaluated whether fluid status could be accurately assessed (and corrected if necessary) prior to right heart catheterisation (RHC), to diagnose accurately post-capillary pulmonary hypertension (PHT) in patients with left heart disease risk factors. A non-invasive measure of fluid status prior to RHC identified fluid-depleted patients. Baseline RHC measurements were performed, and a novel provocation technique (passive leg raise) was compared to a 'one-dose-fits-all' fluid challenge and found to be equivalent.
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Internal medicine journal · Feb 2025
Healthcare burden of public hospital gout admissions in New South Wales, Australia.
In New Zealand, the Māori and Pacific Islander population has a higher rate of hospital admissions for gout; however, we lack data for these population groups who reside in Australia. This study examined the pattern of hospital gout admissions in New South Wales (NSW), the most populous state of Australia, with a particular focus on the Māori and Pacific Islander population. ⋯ This study highlights the ethnic and geographical disparities in gout hospital admissions in NSW, with the Māori and Pacific Islander population of Western and South Western Sydney disproportionately affected. Culturally appropriate gout management strategies may be needed in the Māori and Pacific Islander population to address the large number of gout cases in western and southwestern Sydney.
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Internal medicine journal · Feb 2025
ReviewCurrent state of the non-pharmacological management of irritable bowel syndrome: an up-to-date review of the literature.
Irritable bowel syndrome (IBS) is a complex disorder of gut-brain interaction (DGBI) that is thought to affect a significant proportion of the population. As a result of the nature of IBS, it is hard to predict treatment efficacy as all individuals respond differently, and thus multidisciplinary treatment has become increasingly of interest as it targets multiple aspects of IBS at the same time. Here, we aim to review the literature of both multidisciplinary and single-discipline therapy for IBS. ⋯ GDH was also found to be efficacious, but 83.3% of studies examined a refractory IBS population. There is a lack of literature looking at how multidisciplinary care and different combinations of disciplines work to treat those with IBS in secondary care. Further studies are required for a greater understanding of how multidisciplinary care may be utilised to better manage IBS.
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Pain is a common presenting symptom to consultant physicians, both in the hospital and in the clinic or rooms. Biologically, pain serves as warning of tissue damage. But this is no longer the case when pain is present for months or years, especially when it has been fully investigated. ⋯ The response to the so-called 'opioid epidemic' has led to a renewed focus on how chronic pain should be managed. The aim of this article is to update fellows and trainees on the assessment and management of chronic pain in adult medical patients. In particular, we address the role of pharmacotherapy post-opioid epidemic (primarily antidepressants and anticonvulsants in neuropathic pain), the place of interventional procedures and the nature and effectiveness of pain self-management training in people with chronic pain, many of whom have had pain for a year or more and failed other treatments.
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Internal medicine journal · Feb 2025
The impact of the COVID-19 pandemic on hospital presentations in adults with gastrointestinal infections at a tertiary centre in Australia.
The COVID-19 pandemic resulted in the enactment of substantial public health measures aimed at reducing the transmission of respiratory viruses. The impact of these measures on gastrointestinal (GI) infections remains unexplored. ⋯ There was a substantial decrease in hospital admissions with GI infections, particularly Norovirus, during the COVID-19 pandemic. Admissions because of Clostridioides increased. Stringent public health measures reducing interpersonal contact and increased antibiotic prescribing respectively may explain these changes, while an increased reluctance to seek medical care may also have contributed to the sharp overall decrease in hospitalisations.