Internal medicine journal
-
This review will provide an overview of the currently available approaches to obesity management available in Australia, including the various approaches to lifestyle intervention, in addition to evaluating the safety and efficacy of adjuvant therapies, including pharmacotherapy and bariatric surgery.
-
Internal medicine journal · Jul 2017
Management of hypoxaemic respiratory failure in a Respiratory High-dependency Unit.
There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-intensive care unit (ICU) settings. ⋯ Initial R-HDU management is an effective option in selected HRF to reduce ICU demand, although mortality and clinical deterioration despite NIV are more common than in HCRF.
-
Internal medicine journal · Jun 2017
ReviewDental complications of gastro-oesophageal reflux disease: guidance for physicians.
There is potential for gastro-oesophageal reflux disease (GORD) to be under-diagnosed by physicians. A quick, focused examination, requiring no special equipment, of a patients' dentition can assist in making a more accurate diagnosis where GORD is suspected. Guidance is provided for physicians as to what intra-oral signs are suggestive of intrinsic dental erosion, which is a clinical feature of GORD and its associated conditions. Use of this information will, it is suggested, improve outcomes for patients where GORD is suspected.
-
Internal medicine journal · Jun 2017
ReviewOpioid addiction and misuse in adult and adolescent patients with cancer.
In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. ⋯ Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem.