Internal medicine journal
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Internal medicine journal · Apr 2020
Historical ArticleCook's Endeavour, ship of discovery or ship of distemper: an assessment after 250 years.
The 250-year anniversary of Cook's landfall at Botany Bay on 28 April 1770, approximately half way through a global circumnavigation, was an extraordinary maritime undertaking. An enterprise of astronomy, cartography, cultural-botanical documentation and revelation achieved without a death from infectious disease and only 10 mild cases of scurvy in a ship's company of 95 men. The subsequent homeward journey was far less endurable, marked by shipwreck, unforeseen prolonged delays and fatal epidemics of flux and malaria. Mild scurvy within a handful of souls in a crew experimenting with several putative antiscorbutics, yet at voyage's end the precise treatment of scurvy remained enigmatic.
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Internal medicine journal · Apr 2020
ReviewParenteral nutrition in adults during acute illness: a clinical perspective for clinicians.
Parenteral nutrition (PN) is the administration of a nutritional formula by means other than the gastrointestinal (GI) tract. The formula may include carbohydrates, amino acids, lipids, electrolytes and/or micronutrients. The primary indications for PN are intestinal failure (IF) due to an underlying disease or treatment, or if the GI tract is not accessible. ⋯ Monitoring clinical, laboratory and metabolic parameters in acute IF is essential to provision of safe nutritional support. When provided to appropriate patients with IF in a timely and considered manner, PN has been shown to be safe, improve nutritional parameters and reduce complications associated with malnutrition. This review aims to provide clinicians a practical guide for the management of PN in adult patients within the acute setting.
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Internal medicine journal · Apr 2020
Cardio-geriatric model of care in acute heart failure: initial experience of a multidisciplinary approach in complex elderly patients.
A 'cardio-geriatric' heart failure model of care was implemented to address the high rates of readmission in elderly acute decompensated heart failure patients. Despite demonstrably intensified management in both the cardiology and geriatric domains, this study did not demonstrate a positive effect on the primary outcome of all cause readmissions at 30 days.