Internal medicine journal
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Internal medicine journal · Jul 2022
COVID-19 pandemic 2020 - A tertiary Melbourne hospital's experience.
The COVID-19 pandemic has affected different parts of Australia in distinct ways across 2020 and 2021. In 2020, Melbourne was the epicentre of COVID-19. As one of the key tertiary centres caring for the patients affected by the outbreaks, the Royal Melbourne Hospital (RMH) managed the majority of the Victorian inpatient caseload. ⋯ The experience of this health service in 2020 demonstrated changing demographics over time, with associated differences in outcomes; notably marked mortality in older populations, frequent complications and limited inter-site transfer possible with mobilised resources.
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Internal medicine journal · Jul 2022
Rhabdomyolysis-associated acute kidney injury: clinical characteristics and intensive care unit transfer analysis.
Information on rhabdomyolysis-associated acute kidney injury (AKI) in the emergency department or general ward is limited. ⋯ Rhabdomyolysis-associated AKI was common in the emergency department or general ward and led to more severe outcomes. It was also associated with an increased risk of ICU transfer.
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Internal medicine journal · Jul 2022
Invasive versus Conservative Management in Patients ≥85 years presenting with Non-ST Elevation Myocardial Infarction.
Guidelines recommend early coronary angiography (CA) in patients with non-ST-elevation myocardial infarction (NSTEMI) irrespective of age. However, elderly patients are less likely to be treated according to these guidelines due to their perceived high risk and medical comorbidities. Whether an invasive strategy is associated with improved survival in patients aged ≥85 years remains uncertain due to their exclusion from randomised trials. ⋯ In patients aged ≥85 years who presented with NSTEMI, invasive management was associated with improved survival without significant differences in bleeding or stroke. A randomised controlled study assessing the efficacy and safety of invasive management in very elderly patients with NSTEMI is warranted.