Internal medicine journal
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Internal medicine journal · Apr 2021
Developing critical thinking skills for delivering optimal care.
Healthcare systems across the world are challenged with problems of misdiagnosis, non-beneficial care, unwarranted practice variation and inefficient or unsafe practice. In countering these shortcomings, clinicians must be able to think critically, interpret and assimilate new knowledge, deal with uncertainty and change behaviour in response to compelling new evidence. ⋯ It is important to define these skills explicitly, explain their rationales, describe methods of instruction and provide examples of optimal application. Educational methods for developing and refining these skills must be embedded within all levels of clinician training and continuing professional development.
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Internal medicine journal · Apr 2021
Case ReportsLack of phenotypic additive effect of familial defective apolipoprotein B3531 in familial hypercholesterolaemia.
Familial defective apolipoprotein (apo) B (FDB) and familial hypercholesterolaemia (FH) are the two common genetic conditions that cause hypercholesterolaemia. R3531C mutation of the APOB gene is a rare cause of FDB. Individuals with both FDB and FH are rare. ⋯ R3531C mutation, and our results show that this mutation has no effect in LDLR p. Y398X/APOB p. R3531C double heterozygotes.
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Internal medicine journal · Apr 2021
Medication use and cognitive impairment among residents of aged care facilities.
Potentially inappropriate polypharmacy is common in residential aged care facilities (RACF). This is of particular concern among people with cognitive impairment who, compared with cognitively intact residents, are potentially more sensitive to the adverse effects of medications. ⋯ Our findings highlight the need for optimising prescribing in RACF residents, with particular attention to medications with anti-cholinergic effects.
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Internal medicine journal · Apr 2021
Australia's problem with obtaining consent for psychotropic use in older people.
Frequent use of psychotropic medicines in people with dementia is a significant concern globally, doing this without informed consent is a violation of human rights, ethics and law. Capacity Australia piloted an intervention to address several hypothetical barriers to obtaining consent for psychotropic use in aged care and has developed a suite of resources to improve rights and health literacy for clinicians, patients and community alike.
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Internal medicine journal · Apr 2021
Letter Case ReportsAn unusual presentation of neuro-ophthalmic syphilis.