Internal medicine journal
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Internal medicine journal · Nov 2021
Randomized Controlled TrialComparison of High-Flow and Conventional Nasal Cannula Oxygen in Patients Undergoing Endobronchial Ultrasonography.
Oxygen therapy is required to prevent hypoxaemia during the endobronchial ultrasonography (EBUS) procedure. ⋯ Oxygen therapy delivered by HFNC seems to be safer and more effective than by CNC in patients undergoing EBUS. Oxygen therapy with HFNC may be considered as an alternative to CNC because it may increase patient comfort and thereby improve compliance.
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Internal medicine journal · Nov 2021
Consensus guidelines for the diagnosis and management of invasive aspergillosis, 2021.
Invasive aspergillosis (IA) in haematology/oncology patients presents as primary infection or breakthrough infection, which can become refractory to antifungal treatment and has a high associated mortality. Other emerging patient risk groups include patients in the intensive care setting with severe respiratory viral infections, including COVID-19. These guidelines present key diagnostic and treatment recommendations in light of advances in knowledge since the previous guidelines in 2014. ⋯ Recommendations for paediatric treatment broadly follow those for adults. For breakthrough and refractory IA, a change in class of antifungal agent is strongly recommended, and agents under clinical trial may need to be considered. Newer immunological-based imaging modalities warrant further study, while surveillance for IA and antifungal resistance remain essential to informing the relevance of current treatment recommendations.
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Internal medicine journal · Nov 2021
Polypharmacy And The Use Of Low Or Limited Value Medications In Advanced Cancer.
Patients with advanced malignancy are often on medications for co-morbidities, including those for primary or secondary prevention. The benefit from these medications can be limited and may result in adverse effects, interact with medications used for the malignancy or associated symptoms, increase pill burden and reduce quality of life. ⋯ Polypharmacy and continued prescribing of low or limited value medications was identified in a high proportion of patients. Further studies are needed to assess the impact of continuing these medications, as well as investigation of patient and physician attitudes towards de-escalation.