Internal medicine journal
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Internal medicine journal · Nov 2016
The revolving door: antibiotic allergy labelling in a tertiary care centre.
Patients frequently report antibiotic allergies; however, only 10% of labelled patients have a true allergy. ⋯ AAL are common, but poorly documented in hospital records. Patients with AAL are significantly more likely to require alternative antibiotics and hospital readmissions. There may be a role for antibiotic allergy delabelling to mitigate the clinical and economic burdens for patients with invalid allergy labels.
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Internal medicine journal · Nov 2016
Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation.
Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts. ⋯ Justification of modes other than tablets/capsules and variable understanding about cannabis and trials will need addressing in trial-related information to optimise recruitment and ensure that consent is properly informed.
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Internal medicine journal · Nov 2016
Return to sender: the need to re-address patient antibiotic allergy labels in Australia and New Zealand.
Antibiotic allergies are frequently reported and have significant impacts upon appropriate prescribing and clinical outcomes. We surveyed infectious diseases physicians, allergists, clinical immunologists and hospital pharmacists to evaluate antibiotic allergy knowledge and service delivery in Australia and New Zealand. ⋯ A high burden of antibiotic allergy labelling and demand for AAT is complicated by a relative lack availability or awareness of AAT services in Australia and New Zealand. Antibiotic allergy education and deployment of AAT, accessible to community and hospital-based clinicians, may improve clinical decisions and reduce antibiotic allergy impacts. A collaborative approach involving infectious diseases physicians, pharmacists and allergists/immunologists is required.
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Internal medicine journal · Nov 2016
Detection and clinical significance of glomerular M-type phospholipase A2 receptor in patients with idiopathic membranous nephropathy.
Glomerular M-type phospholipase A2 receptor (PLA2 R) is important for diagnosing idiopathic membranous nephropathy (IMN). The relation between glomerular PLA2 R expression and response to treatment remains to be explored. ⋯ The positive rate of glomerular PLA2 R was more prevalent in IMN patients. Both PLA2 R and IgG4 glomerular deposits may help in discriminating between idiopathic and secondary membranous nephropathy. IMN patients with positive PLA2 R expression probably have a more beneficial response to glucocorticoid and/or immunosuppressant therapy.
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Internal medicine journal · Oct 2016
ReviewThe limitations in implementing and operating a rapid response system.
Despite the widespread introduction of rapid response systems (RRS)/medical emergency teams (MET), there is still controversy regarding how effective they are. While there are some observational studies showing improved outcomes with RRS, there are no data from randomised controlled trials to support the effectiveness. Nevertheless, the MET system has become a standard of care in many healthcare organisations. In this review, we present an overview of the limitations in implementing and operating a RRS in modern healthcare.