Internal medicine journal
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Granulomatous amoebic encephalitis is a rare but likely under-recognised form of subacute, usually fatal, encephalitis. We present an illustrative case report and literature review of Australian cases, summarising clinical features, diagnostic methods, treatment and outcomes.
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Shoulder weakness with unilateral scapular winging is a common issue that initially presents to the general physician, sports physician or rheumatologist. Although most of these cases are neurogenic in nature, it is important to consider alternative causes for unilateral scapular winging. Muscular dystrophies can present with marked asymmetry, the most typical being facioscapulohumeral dystrophy (FSHD). We describe a case of FSHD with a summary of the key clinical features to increase the awareness of this condition among physicians.
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Internal medicine journal · Oct 2024
A national study of infective endocarditis models of care in Australia.
Multidisciplinary endocarditis team (MDET) management is supported by current evidence and recommended in international society guidelines. The extent to which this recommendation has been implemented in Australian centres and the attitudes, barriers and facilitators of this model are unclear. ⋯ Even though it is recommended in international guidelines, the MDET model is used by less than one-third of Australian specialist referral centres. Stakeholders in IE care have generally favourable attitudes towards MDET implementation but cite a lack of resources, funding, collaboration and time as barriers to this. Dedication of financial and administrative support and leadership from key stakeholders are required to increase MDET utilisation.
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Internal medicine journal · Oct 2024
Meta AnalysisGlobal meta-analysis of physicians' experiences of workplace sexual harassment by patients.
The World Health Organization recognises that sexual harassment is an occupational hazard in medicine, but the prevalence of sexual harassment by patients is unknown. This global meta-analysis found that a pooled prevalence of 45.13% of 18 803 physicians from several specialities (e.g. internal medicine and surgery) have ever experienced it. Hospitals should implement protective measures such as panic alarms for night shifts and isolated wards.
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Internal medicine journal · Oct 2024
Randomized Controlled Trial Multicenter StudyThe Australian Team Approach to Polypharmacy Evaluation and Reduction (AusTAPER) hospital study: effect of a collaborative medication review on the number of current regular medicines for older hospital inpatients.
Potentially harmful polypharmacy is a growing public health concern. This article aims to evaluate the effectiveness of a structured Team Approach to Polypharmacy Evaluation and Reduction (AusTAPER) framework. ⋯ Medicines were significantly reduced in both groups, with a trend to a larger reduction in medicines at 12 months in the intervention group. The intervention cost was approximately offset by sustained reduced medicines cost, although these results should be regarded cautiously because of the absence of significance in the differences in outcomes between groups.