Internal medicine journal
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Internal medicine journal · Apr 2023
Prospective associations between pain at multiple sites and falls among community-dwelling older Australians.
Pain at multiple sites is prevalent among older people. However, studies investigating the relationship between pain and falls focus largely on single-site pain. ⋯ Falls risk should be ascertained for older people with pain, irrespective of whether they present with a single or multiple sites pain. Nevertheless, older adults with multisite pain may require additional attention as they appear to have a significantly elevated risk of multiple falls.
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Internal medicine journal · Apr 2023
Benefit and harm of anticoagulation in the prevention of thromboembolic stroke for non- valvular atrial fibrillation in haemodialysis patients - a Top End of Northern Australia study.
Warfarin for the prevention of non-valvular atrial fibrillation (AF)-related thromboembolic stroke in patients on maintenance haemodialysis is controversial. Despite the exclusion of haemodialysis patients in randomised control trials, the American Heart Association/American College of Cardiology has recommended warfarin in high-risk AF patients. ⋯ This retrospective study of prevalent haemodialysis patients with co-existing history of non-valvular AF failed to demonstrate sufficient evidence for the routine use of warfarin for prophylaxis of thromboembolic stroke.
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Several surgical and percutaneous treatments are available for patients with aortic valve disease. ⋯ Rates of AVR have increased significantly over the past 16 years, particularly in the elderly. Despite international guideline recommendations, fewer mechanical AVR are being used in younger cohorts. The uptake in TAVI rates might reflect evidence that suggests it is a safe alternative, at least in the medium term. BAV has also seen a resurgence during this time period.
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Internal medicine journal · Apr 2023
Attitudes, practices, and experiences of medical specialists towards email communication with their patients.
The medical profession has been slow in embracing email as a means of improving communication with patients. ⋯ There is a want and need for comprehensive and accessible professional guidance on email use with patients. Our results indicate opportunities to inform good clinical practice in respect of doctor-patient relationships, clinical workloads and risk management. There is also a need for formal guidelines on emailing with patients. The COVID-19 pandemic has heightened the need for such guidelines.