Internal medicine journal
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Internal medicine journal · Dec 2021
The psychosocial burden of inflammatory bowel disease in adolescents and young adults.
This study examined the psychosocial burden of inflammatory bowel disease (IBD) in young people aged 15-25 years attending a tertiary specialist health centre for adolescents and young adults in Brisbane. ⋯ Early recognition and treatment of depression and other psychosocial comorbidities within integrated pathways of care is crucial in adolescents and young adults with IBD and likely to improve the course of IBD and their overall health and well-being. Interventions aimed at enhancing self-efficacy and increasing public awareness are also likely to be helpful.
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Internal medicine journal · Dec 2021
The Victorian Lung Cancer Service Redesign Project: Impacts of a Quality Improvement collaborative on timeliness and management in lung cancer.
Lung cancer management is characterised by a high disease burden, poor survival and substantial variation in management and outcomes. Service redesign provides opportunities for quality improvement (QI) and this improvement may be leveraged across multiple sites using QI collaboration. ⋯ Data-driven redesign initiatives enable identification and analysis of clinical practice variation and may be utilised to enhance timeliness of cancer care and improve local data service capabilities.
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Internal medicine journal · Dec 2021
Critical peptic ulcer bleeding requiring massive blood transfusion: outcomes of 270 cases.
Critical peptic ulcer bleeding requiring massive transfusion is a gastroenterological emergency. Few data exist on management and outcomes. The Australian and New Zealand Massive Transfusion Registry collects comprehensive data on adult patients receiving massive transfusion across all bleeding contexts. ⋯ One in five patients with critical peptic ulcer bleeding requiring massive transfusion died by 30 days. Mortality was associated with patient characteristics rather than clinical interventions (e.g. procedures, blood product transfusion).
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Internal medicine journal · Dec 2021
Frailty status, timely goals of care documentation and clinical outcomes in older hospitalised medical patients.
Hospitalised frail older patients are at risk of clinical deterioration. Early goals of care (GOC) documentation is vital to avoid futile/unwarranted interventions in the event of deterioration. ⋯ Older frail hospitalised patients were more likely to have timely GOC than older non-frail patients. Timely GOC in such patients may avoid burdensome treatments.
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Internal medicine journal · Dec 2021
Associations between socioeconomic status and place of residence with survival after aneurysmal subarachnoid haemorrhage.
This study aims to understand early (<24 h post ictus) and late (up to 12 months) survival post aneurysmal subarachnoid haemorrhage (aSAH), with a focus on rurality and socioeconomic status. ⋯ We found high early death in this population-based aSAH Australian population. Survival to 12 months after aSAH was not related to either geographical location or socioeconomic status but modifiable risk factors increased the risk of death.