Internal medicine journal
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Internal medicine journal · May 2017
Multicenter StudyBronchial thermoplasty in severe asthma in Australia.
Bronchial thermoplasty (BT) is an approved bronchoscopic intervention for the treatment of severe asthma. However, limited published experience exists outside of clinical trials regarding patient selection and outcomes achieved. ⋯ BT is a safe procedure which can achieve clinical improvement in those with uncontrolled symptoms and severe airflow obstruction.
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Internal medicine journal · May 2017
Impact of an antimicrobial stewardship intervention on appropriateness of prescribing for community-acquired pneumonia in an Australian regional hospital.
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
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Internal medicine journal · May 2017
Case ReportsA rare vascular complication in a patient with essential thrombocythaemia: spontaneous abdominal aortic dissection.
A 27-year-old woman complained of waist and back pain. Abdominal computed tomography angiography showed abdominal aortic dissection, the blood count revealed a high platelet count of 1655 × 109 /L. ⋯ Cases of abdominal aortic dissection in ET have not been previously reported. As such, we proposed a mechanism of abdominal aortic dissection caused by endothelial dysfunction and further emphasised appropriate management in ET with abdominal aortic dissection.
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Internal medicine journal · Apr 2017
Advance Care Planning: is quality end of life care really that simple?
The routine implementation of Advance Care Planning (ACP) is now a prominent feature of policy directed at improving end of life care in Australia. However, while complex ACP interventions may modestly reduce medical care at the end of life and enable more people to die at home or outside of acute hospital settings, existing legal, organisational, cultural and conceptual barriers limit the implementation and utility of ACP. We suggest that meaningful improvements in end of life care will not result from the institutionalisation of ACP but from more significant changes to the design and delivery of care.