Internal medicine journal
-
Internal medicine journal · Apr 2020
Case ReportsSuccessful kidney transplantation in a patient with stable multiple myeloma.
Renal failure is a common feature of multiple myeloma affecting 20-55% of patients at the initial presentation and is being associated with a significant increase in morbidity and mortality. Renal transplantation for patients with multiple myeloma is rarely considered given the incurable nature of the disease, the risk of post-transplant disease progression and perceived high risk of infections. ⋯ Transplantation has been successful and with excellent kidney function and stable multiple myeloma 6 years post-transplant. This case highlights the potential benefits of renal transplantation in highly selected patients with multiple myeloma.
-
Internal medicine journal · Apr 2020
U-shaped association of vigorous physical activity with risk of metabolic syndrome in men with low lean mass, and no interaction of physical activity and serum 25-hydroxyvitamin D with metabolic syndrome risk.
There is uncertainty over how lean mass, physical activity (PA) and 25-hydroxyvitamin D (25-OH-D) status interact on metabolic syndrome (MetS) risk in adults. ⋯ Men and women with high lean mass have low risk of MetS regardless of PA. Low lean mass identifies men who may benefit most from increasing PA, with an optimal level associated with lowest risk. 25-OH-D and PA do not interact on MetS risk.
-
Internal medicine journal · Apr 2020
Enterococcal bacteraemia 'silent but deadly': a population-based cohort study.
The high mortality rate of patients with enterococcal infections has been shown to be associated with the severity of underlying comorbidities. ⋯ Microbiological cure was inversely associated with 30-day mortality. The presence of underlying urological and colorectal malignancy was a predictor of 1-year mortality. We identified the importance of evaluating patients with Enterococcus faecalis bacteraemia for underlying colorectal neoplasia. Routine colonoscopy is recommended in patients with E. faecalis bacteraemia or infective endocarditis with an unclear source of infection.
-
Internal medicine journal · Apr 2020
Performance of risk models predicting cardiac complications in pregnant women with congenital heart disease: a meta-analysis.
Accurate risk stratification is important in pregnant women including the growing population with congenital heart disease (CHD). We meta-analysed the performance of risk models for CHD women. ⋯ Pooled c-statistics (95% confidence interval) for scores were mWHO 0.71 (0.65-0.76), CARPREG 0.66 (0.61-0.71) and ZAHARA 0.71 (0.65-0.76). Current risk models had at best moderate discrimination for CHD women with significant room for improvement.