Internal medicine journal
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Internal medicine journal · Feb 2023
Hyponatraemia caused by transient syndrome of inappropriate antidiuresis to urinary retention.
Hyponatraemia is frequently seen in the emergency department, possibly caused by the syndrome of inappropriate antidiuresis (SIAD). We report three cases in which we believe urinary retention with bladder distention caused hyponatraemia. ⋯ Brisk diuresis occurred after placement of an indwelling urinary catheter with overly correction of sodium for which treatment was necessary. Clinicians should be aware that placement of an indwelling urinary catheter may prompt brisk water diuresis and a tendency to overcorrection.
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Internal medicine journal · Feb 2023
ReviewNon-ischaemic Dilated Cardiomyopathy: Recognising the Genetic Links.
The landscape of genetically related cardiac disease continues to evolve. Heritable genetic variants can be a primary cause of familial or sporadic dilated cardiomyopathy (DCM). There is also increasing recognition that genetic variation is an important determinant of susceptibility to acquired causes of DCM. ⋯ Identifying patients who are most likely to benefit from genetic testing is paramount. The objective of this review is to highlight the importance of recognising genetic DCM, key genotype-phenotype correlations and the value of genetic testing in clinical management for both the individual and their family. This is likely to become more relevant as management strategies continue to be refined with genotype-specific recommendations and disease-modifying therapies.
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Internal medicine journal · Feb 2023
CommentImpact of travel distance on outcomes for clinical trial patients - The Kinghorn Cancer Centre (TKCC) Experience.
Geographic isolation and travel distance to specialist care is a known social determinant of health and contributes to poorer oncology survival outcomes. ⋯ All patients should be considered for clinical trial referral based on clinical parameters and preference, regardless of geographic proximity. In the meantime, improving access to clinical trials for rural and regional patients continues to be a priority.
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Internal medicine journal · Feb 2023
Idiopathic factor V inhibitor in a patient starting haemodialysis.
A 74-year-old Pacific Island man with end-stage renal failure planning to start haemodialysis presented with persistent bleeding after tunnelled dialysis catheter insertion. The laboratory findings revealed a prolonged activated partial thromboplastin time of 118 s, prothrombin ratio of 4.2, factor V activity of <2% and a factor V inhibitor of 40 Bethesda Units. No clear underlying aetiology was identified. The bleeding settled with conservative measures and the factor V inhibitor was successfully treated with oral cyclophosphamide for 6 weeks.