Internal medicine journal
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Internal medicine journal · Jan 2015
Trends in the incidence of intensive care unit invasive mechanical ventilation and subsequent 2-year survival in very elderly New Zealanders.
The number of elderly in the general population is growing. There are therefore implications for the provision of intensive care unit (ICU) care to elderly patients. ⋯ For very elderly patients over the period 1999-2009, the population rate of IMV was static and 2-year mortality declined.
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Internal medicine journal · Dec 2014
ReviewConsensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014.
Pneumocystis jirovecii infection (PJP) is a common cause of pneumonia in patients with cancer-related immunosuppression. There are well-defined patients who are at risk of PJP due to the status of their underlying malignancy, treatment-related immunosuppression and/or concomitant use of corticosteroids. Prophylaxis is highly effective and should be given to all patients at moderate to high risk of PJP. Trimethoprim-sulfamethoxazole is the drug of choice for prophylaxis and treatment, although several alternative agents are available.
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Internal medicine journal · Dec 2014
Association between pre-donation serum uric acid concentration and change in renal function after living kidney donation in women.
Reduction in renal mass after unilateral nephrectomy causes functional and structural changes in the remaining kidney. ⋯ Pre-donation SUA concentration is associated independently with the change in renal function after donor nephrectomy in women but not in men.
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Internal medicine journal · Dec 2014
Randomized Controlled Trial Multicenter StudyMetoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study.
Limited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups. ⋯ Metoclopramide appears to be a promising candidate for the treatment of patients with intractable hiccups, with mild adverse events. However, further clinical trials are required to confirm these results.
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Internal medicine journal · Dec 2014
ReviewConsensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2014.
There is a strong argument for the use of antifungal prophylaxis in high-risk patients given the significant mortality associated with invasive fungal disease, the late identification of these infections, and the availability of safe and well-tolerated prophylactic medications. Clinical decisions about which patients should receive prophylaxis and choice of antifungal agent should be guided by risk stratification, knowledge of local fungal epidemiology, the efficacy and tolerability profile of available agents, and estimates such as number needed to treat and number needed to harm. ⋯ These include the availability of new medications and/or formulations, and a focus on refining and simplifying patient risk stratification. Used in context, these guidelines aim to assist clinicians in providing optimal preventive care to this vulnerable patient demographic.