Internal medicine journal
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Internal medicine journal · Sep 2018
Multicenter StudyClinical risk factors for acute ischaemic and haemorrhagic stroke in patients with infective endocarditis.
Stroke as a complication of infective endocarditis portends a poor prognosis, yet risk factors for stroke subtypes have not been well defined. ⋯ Among patients with IE, there exist characteristics that relate differentially to ischaemic and haemorrhagic stroke risk.
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Internal medicine journal · Sep 2018
Multicenter StudySuboptimal behaviour and knowledge regarding overnight glycaemia in adults with type 1 diabetes is common.
In people with type 1 diabetes (T1D), nocturnal hypoglycaemia (NH) can be slept through and can cause seizures, arrhythmias and death. Hypoglycaemia avoidance can induce hyperglycaemia and ketosis. Patient behaviour impacts clinical outcomes and may be changed by education. ⋯ Many adults with T1D have suboptimal knowledge and behaviour regarding overnight BG self-management. A survey, piloted herein, may facilitate the identification of patients who could benefit from further education.
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Internal medicine journal · Sep 2018
Multicenter StudyAge-adjusted cut-off using the IL D-dimer HS assay to exclude pulmonary embolism in patients presenting to emergency.
The ADJUST-PE study showed that an age-adjusted D-dimer (AADD) (age years × 10 ng/mL if >50 years) combined with an unlikely pre-test probability (PTP) can increase the proportion of older patients in whom pulmonary embolism (PE) can be safely excluded, but the IL D-dimer HS assay was not assessed. To assess the ability of the IL D-dimer HS assay to exclude PE using the AADD. ⋯ The absolute increase in efficiency of an AADD compared to conventional cut-off using the IL D-dimer HS assay is modest (~10%) and requires prospective validation. Modifying our cut-off to 230 ng/mL and systematic implementation of a clinical algorithm, including D-dimer testing and PTP, is likely a more important first step.
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Internal medicine journal · Sep 2018
Randomized Controlled TrialMusic reduces state anxiety scores in patients undergoing pleural procedures: a randomised controlled trial.
Patient anxiety is an often overlooked complication of pleural diagnostic and therapeutic procedures. Listening to music is effective in reducing patient anxiety in some endoscopy procedures but has not yet been evaluated in pleural procedures. ⋯ Listening to music appears to be beneficial in reducing anxiety in patients undergoing pleural procedures.
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Internal medicine journal · Sep 2018
End-stage renal disease patients using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may reduce the risk of mortality: a Taiwanese Nationwide cohort study.
The association between the use of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) and mortality in end-stage renal disease (ESRD) patients lacks sufficient evidence. ⋯ In this large-scale, population-based cohort study, ESRD patients using ACEI/ARB had a lower risk of CV death and all-cause mortality than non-users did.