Internal medicine journal
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Internal medicine journal · Jun 2021
An audit of the effect of SGLT2 inhibitor cessation in a pre-admission clinic before and after Australian Diabetes Society guidelines.
Perioperative ketoacidosis is an important adverse event related to the use of sodium glucose co-transporter 2 inhibitor (SGLT2i). We compared perioperative outcomes in patients on SGLT2i, before and after protocolised pre-operative cessation of the drug. There were no cases of clinically detected diabetic ketoacidosis in the 96 patients included in the study. Withdrawal of SGLT2i did not appear to alter significantly pre-operative glycaemia.
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Internal medicine journal · Jun 2021
Hepatitis B in the Northern Territory: insights into the changing epidemiology of an ancient condition.
Aboriginal and Torres Strait Islander people are disproportionately affected by hepatitis B virus (HBV) infection. A proposed mismatch between standard vaccines and the HBV/C4 sub-genotype prevalent in Aboriginal people in the Northern Territory (NT) may reduce vaccine effectiveness. ⋯ The burden of CHB in Indigenous people in the NT has previously been underestimated. A higher HBV prevalence in the NT than described in previous cross-sectional studies was found, including a higher prevalence in Indigenous people. Evidence of suboptimal vaccine efficacy was demonstrated predominantly in Indigenous individuals.
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Internal medicine journal · Jun 2021
Understanding cough in interstitial lung disease: a cross-sectional study on the adequacy of treatment.
Cough is a common symptom in interstitial lung disease (ILD), often leading to treatment dissatisfaction for patients and physicians. ⋯ Cough is prevalent in ILD but is not adequately suppressed. Cough has a significant impact on quality of life, leading patients to adopt their own strategies to control their cough. More research is needed to understand cough mechanisms in ILD and the interplay of other potential co-pathologies.
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Internal medicine journal · Jun 2021
Abrupt change to telephone follow-up clinics in a regional rheumatology service during COVID-19: analysis of treatment decisions.
During the 2020 COVID-19 lockdown our rheumatology service provided follow up by phone. We reviewed clinic documents to compare patients serviced, and patient assessment and treatment outcomes. More patients received care during the lockdown but patient rheumatic disease was deemed active less frequently, more patients had no change to disease-modifying anti-rheumatic drugs and patients were less likely to have an intervention arranged. This suggests careful patient selection and appropriate infrastructure should be part of future rheumatology telemedicine.
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Internal medicine journal · Jun 2021
Optimising participation of persons with cognitive impairment in a national dementia registry: challenges and solutions.
Clinical quality registries are increasingly utilised to monitor and improve healthcare quality. Opt-out consent is recommended to maximise participation and ensure validity of data, however, presents specific considerations when including persons with impaired decision-making abilities. This paper describes the innovative Australian Dementia Network Registry recruitment framework designed to optimise inclusion of people with dementia and mild cognitive impairment.