Internal medicine journal
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Internal medicine journal · Nov 2024
Genetic testing for familial hyperaldosteronism type 1 in Aotearoa/New Zealand.
Primary aldosteronism (PA) is the most common secondary endocrine cause of hypertension with familial hyperaldosteronism type 1 (FH-1), a rare heritable subtype. Timely identification of FH-1 is important because of an increased risk of vascular events in affected individuals and because it provides the opportunity to guide appropriate treatment. Genetic testing is recommended if onset is at a young age (<20 years), there is a family history of PA or early cerebrovascular events occur. ⋯ Testing for FH-1 has increased over time but remains low. Testing for familial forms of PA should be considered in those in whom PA was diagnosed at a young age or with a suggestive family history.
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Internal medicine journal · Nov 2024
Does basic physician trainee selection predict successful progression in the Royal Australasian College of Physicians adult medicine training programme? A retrospective cohort study.
The optimal selection process for basic physician trainees (BPTs) is unclear. ⋯ The predictive capacity of the selection process for success in the RACP clinical examination within the minimum time period is high.
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Internal medicine journal · Nov 2024
The safety of same-day discharge following percutaneous coronary intervention in regional Australia.
Same-day discharge (SDD) following percutaneous coronary intervention (PCI) has proven safe, and global adoption of this strategy has been increasing rapidly. These data are predominantly derived from high-volume, metropolitan centres with a relative paucity of data from regional and remote settings. ⋯ In a regional setting, SDD following elective transradial PCI, in select patients, is a safe approach which was not associated with higher rates of unplanned readmission or adverse clinical outcomes.
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Internal medicine journal · Nov 2024
The experience of an adult diabetic foot unit continuing face-to-face consults during the COVID-19 pandemic.
The COVID-19 pandemic significantly disrupted lower limb diabetes care. We aimed to map trends in diabetes-related lower limb amputation and hospitalisation rates through the COVID-19 pandemic. ⋯ Despite increased hospitalisations for diabetes-related foot complications during COVID-19, there was not a corresponding increase in amputation rates. Face-to-face care of diabetes-related foot complications was prioritised at this centre and may have contributed to stable amputation rates during the pandemic.
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Takotsubo syndrome is a condition characterised by temporary acute left ventricular dysfunction with regional wall abnormalities extending beyond a single coronary artery territory. Initially thought to be benign, this condition, which is challenging to distinguish from acute coronary syndrome, has substantial morbidity and mortality. ⋯ Although beta blockers and angiotensin-converting enzyme inhibitors are used as treatments for left ventricular dysfunction, currently, there are no randomised controlled trials to support their use. In this paper, we review the latest evidence regarding aetiologies, pathophysiology, diagnostic criteria, prognosis, complications and management of Takotsubo syndrome.