Internal medicine journal
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Internal medicine journal · Jun 2021
Lung, breast, and bowel cancer treatment for Aboriginal people in New South Wales: a population-based cohort study.
Aboriginal Australians have higher cancer mortality than non-Aboriginal Australians. Lower rates of cancer treatment among Aboriginal people can contribute to this. ⋯ Aboriginal people were significantly less likely to receive surgery for lung cancer than non-Aboriginal people and had fewer attendances with a surgeon, suggesting a need to strengthen referral pathways.
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Internal medicine journal · Jun 2021
Osteopontin, GLUT1 and Ki67 expression in malignant peritoneal mesothelioma: Prognostic implications.
Malignant peritoneal mesothelioma is the most common primary peritoneal neoplasm. The only universally recognised pathological prognostic factor is histopathological subtype. Prognostic markers based on patient features and clinical stages have been disappointing. ⋯ OPN, Ki-67, treatment and PCI were independent indicators for OS, and a higher level of OPN expression correlated significantly with poorer OS.
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Internal medicine journal · Jun 2021
Australian public hospital inpatient satisfaction related to early patient involvement and shared decision-making in discharge planning.
Surveys of hospital inpatient satisfaction may help develop actionable plans for quality improvement, and patients have preferred to give feedback during admission at the point of service compared to after discharge. However, patient satisfaction measurement has often been done by questionnaires post-discharge, and without focussing on an Australian general internal medicine setting. ⋯ In an Australian general internal medicine service, early involvement and shared decision-making in discharge planning are valued by patients. Incorporating checking of patients' understanding of diagnoses, management, discharge instructions, and follow-up plans into ward round routines may benefit patient satisfaction. This study stimulates further research into the use of a proforma to capture and check patients' understanding of discharge diagnoses and plans.
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Internal medicine journal · Jun 2021
Retrospective single-centre analysis of diagnostic approach to adult-onset haemophagocytic lymphohistiocytosis.
Haemophagocytic lymphohistiocytosis (HLH) is a rare disorder with a poor prognosis characterised by substantial immune activation leading to end-organ failure. In childhood, genetic defects that impair cytotoxic function of natural killer cells and T cells. (HLH) are often identified. In adults, clinical manifestations are similar to those observed in children but the aetiology is often unclear. ⋯ The present study highlights the importance of comprehensive application of diagnostic criteria to improve accuracy and timelines of the diagnosis of adult onset HLH.
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Internal medicine journal · Jun 2021
Presenting symptoms of COVID-19 and clinical outcomes in hospitalised older adults.
In July 2020, a COVID-19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care. ⋯ COVID-19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course.