Internal medicine journal
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Fibromyalgia presents with symptoms of widespread pain, fatigue, sleeping and cognitive disturbances as well as other somatic symptoms. It often overlaps with other conditions termed 'central sensitivity syndromes', such as irritable bowel syndrome, chronic fatigue syndrome and temporomandibular disorder. Central sensitisation, mediated by amplified processing in the central nervous system, has been identified as the key pathogenic mechanism in these disorders. ⋯ Such tools can fulfil an important need when managing patients with rheumatic disease and other chronic diseases as a way to identify fibromyalgia and improve patient outcomes. Treatment involves an integrated approach including education, exercise, stress reduction and pharmacological therapies targeting the central nervous system. This approach is suitable for all presentations of central sensitivity and some central sensitivity syndromes have additional treatment options specific to the clinical presentation.
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Internal medicine journal · Dec 2021
Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: A cross-sectional survey.
A resuscitation plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances. ⋯ Most junior doctors feel confident discussing and documenting resuscitation plans. There is a need to improve knowledge about legal obligations to follow completed resuscitation plans, and about when resuscitation plans should be completed to ensure they are completed with patients who are most at risk.
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Internal medicine journal · Dec 2021
No effect of sleeved arms on the accuracy of blood pressure measurement.
It is recommended that blood pressure should be measured on a bare upper arm with an appropriately sized cuff. However, in practice, it is more convenient to measure blood pressure on sleeved arms. ⋯ In the present study, we concluded that there was no significant effect of sleeved arms on the accuracy of blood pressure measurement by using an electronic oscillometric sphygmomanometer equipped with a conventional cuff.
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Internal medicine journal · Dec 2021
Discussion of Advance Care Planning on end of life decisions with lung cancer patients in Wuhan China: Attitude, Timing, and Future Directions.
Progress in advance care planning (ACP) in China has been hindered for decades compared with other countries. ⋯ Chinese patients showed preferences towards ACP, but with inadequate knowledge. More assistance is needed with ACP for those patients, especially for females, patients with one child and those with early stage lung cancer. For female patients and patients receiving treatment, doctors may initiate ACP dialogue first.