Internal medicine journal
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Internal medicine journal · Nov 2022
Cannula provoked upper extremity superficial vein thrombophlebitis: are we overtreating?
Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years (range 20-91), with symptomatic UESVT revealed varied management including symptomatic management (37%), prophylactic (37%) and higher dose anticoagulation (27%). There was 2% (95% confidence interval (CI) 0-7.6) thrombus extension and 1% (95% CI 0-5.9) major bleeding, both limited to cancer. We argue anticoagulation is unnecessary in most UESVT patients.
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Internal medicine journal · Nov 2022
Can existing electronic medical records be used to quantify cardiovascular risk at point of care?
Using electronic data for cardiovascular risk stratification could help in prioritising healthcare access and optimise cardiovascular prevention. ⋯ Significant gaps are apparent in electronic medical data capture of key variables to perform cardiovascular risk assessment. Medical data capture should prioritise the collection of clinically important data to help address gaps in cardiovascular management.
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The COVID-19 pandemic has exposed the deficiencies of the current healthcare system in terms of a disconnect between primary and tertiary care and increasing subspecialisation, the focus on acute episodic care rather than on prevention in a time where chronic disease prevails and an inefficient use of healthcare resources. Herein, we present the case for an alternative model of healthcare delivery - shared medical appointments - which are efficient, effective and empowering and can be transitioned to the virtual environment successfully. We highlight the barriers to implementation and how these can be overcome.
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Internal medicine journal · Nov 2022
Administration of pharmacological sleep aids prior to, during and following critical illness.
Sleep in the intensive care unit (ICU) is frequently disturbed and this may have a detrimental effect on recovery. ⋯ Pharmacological sleep aids are administered frequently in the ICU with administration increasing substantially after ICU discharge.
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Internal medicine journal · Nov 2022
The landscape of research during post-graduate medical training in New Zealand.
Formalised research opportunities offered to junior doctors in Australasia, and specifically New Zealand, are few and far in between. This is especially evident for interns in the first 2 years after graduation. Academic internships are positioned not only to fill this gap but also provide interns with long-lasting skills beyond the confines of academia.