Internal medicine journal
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Internal medicine journal · Jan 2019
Multicenter StudySubstantial variation exists in spirometry interpretation practices for airflow obstruction in accredited lung function laboratories across Australia and New Zealand.
Spirometry forms the foundation investigation for the diagnosis and monitoring of common pulmonary conditions. However, potential variation in spirometry interpretation for airflow obstruction may impact subsequent clinical management. ⋯ Significant heterogeneity in spirometry interpretation for airflow obstruction exists across Australian and New Zealand accredited lung function laboratories. Lack of standardisation may translate into clinically appreciable differences for the diagnosis and management of common respiratory conditions. Ongoing discussion regarding formal standardisation is required.
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Internal medicine journal · Dec 2018
Radial-probe endobronchial ultrasound outcomes in the investigation of peripheral pulmonary lesions: a New Zealand perspective.
Radial-probe endobronchial ultrasound (radial-EBUS) is becoming an important investigation for peripheral pulmonary lesions (PPL). A key advantage of radial-EBUS is the favourable risk profile compared with current gold-standard computerised tomography-guided biopsy. ⋯ Radial-EBUS was shown to be safe with diagnostic yield similar to international reports. Important predictors of success include distance from hilum, probe position and forceps as first instrument. We also demonstrated that molecular analysis is possible in radial-EBUS obtained samples.
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Internal medicine journal · Dec 2018
Staggering shifts to rebalance night medical registrar workload.
Lone night medical registrars, particularly those working at busy urban hospitals have high workloads and low job satisfaction. Handover of pending referrals from day staff can contribute to further delays in providing care with increased risks for patient safety. ⋯ Rearranging medical registrar shifts can result in significant reduction in night medical registrar workload. It may also have other potential benefits in terms of increased capacity for ward reviews and reduced MET calls/codes.
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Internal medicine journal · Nov 2018
Characteristics of patients who progress from bridging to long-term oxygen therapy.
Patients with persistent hypoxia following an acute hospital admission may be discharged with 'bridging' domiciliary oxygen as per criteria defined by the Thoracic Society of Australia and New Zealand. The need for continuous long-term oxygen therapy (LTOT) is then reassessed at a clinic review 1-2 months later. ⋯ PaO2 at time of discharge provides a signal with the potential to identify who will require continuous LTOT following an acute hospital admission. Additionally, this study highlights the need to re-evaluate patients' oxygen requirements during a period of clinical stability.