Internal medicine journal
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Internal medicine journal · Aug 2013
Multicenter StudyTrends in the use of implantable cardioverter defibrillators in Australia: a 10-year nationwide study from 2000-2009.
Implantable cardioverter defibrillators (ICD) have been demonstrated to reduce mortality in survivors of life-threatening arrhythmias (secondary prevention) and in patients at increased risk of sudden cardiac death (primary prevention). Other nations have reported significant increases in ICD use in recent years. ⋯ ICD procedures increased significantly in Australia between 2000-2009. Despite these increases, other studies have suggested ICD devices are currently under-utilised. During the study period, males accounted for the majority of ICD procedures. While there are numerous reasons for this, it is not known if device under-use is more common in females.
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Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow limitation in the presence of identifiable risk factors. Inflammation is the central pathological feature in the pathogenesis of COPD. In addition to its pulmonary effects, COPD is associated with significant extrapulmonary manifestations, including ischaemic heart disease, osteoporosis, stroke and diabetes. ⋯ Smoking cessation is paramount in managing COPD, with promotion of physical activity and pulmonary rehabilitation being other key factors in management. Comorbidities should be actively sought and managed in their own right. Given the chronicity and progressive nature of COPD, ongoing monitoring and support with timely discussion of advanced-care planning and end-of-life issues are recommended.
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Internal medicine journal · Aug 2013
Investigating polypharmacy and drug burden index in hospitalised older people.
To investigate the changes in polypharmacy and the drug burden index (DBI) occurring during hospitalisation for older people. The secondary aim was to examine the associations of these two measures with the length of hospital stay and admission for falls or delirium. ⋯ In the present study, DBI was associated with an increased risk of hospital admission for delirium only. Polypharmacy was not associated with any of the clinical measures.
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Internal medicine journal · Aug 2013
Students coached for an admission test perform less well throughout a medical course.
Undertaking commercial coaching to improve one's chance of selection into medical school is widespread. Although its effect on selection test performance appears to be relatively minimal, its impact on the predictive validity of the tests is unknown. ⋯ Differences in selection process and learning context between the two cohorts may explain why coaching was only significantly related to the performance of one cohort. Further research is required to ascertain if coached students develop a learning style that hinders ongoing acquisition of knowledge, which might have serious implications for job performance after graduation.