Internal medicine journal
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Internal medicine journal · Jun 2013
Randomized Controlled TrialHyperuricaemia and gout in New Zealand rural and urban Māori and non-Māori communities.
There are few current data on the prevalence of hyperuricaemia and gout in New Zealand, particularly among the indigenous Māori population. ⋯ Gout and hyperuricaemia were more prevalent in Māori, and participants with gout were more likely to have comorbidities. There was not a higher overall adjusted cardiovascular disease risk in Māori participants with gout. Despite the high prevalence of gout, management remains suboptimal.
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Internal medicine journal · Jun 2013
Case ReportsOutpatient parenteral antimicrobial therapy is safe and effective for the treatment of infective endocarditis: a retrospective cohort study.
Outpatient parenteral antibiotic therapy has been shown to be efficacious, safe and cost-effective for a variety of infections. The data from managing infective endocarditis (IE) with hospital in the home (HITH) are limited. We evaluated the safety and outcomes of patients with IE treated with HITH at our centre. ⋯ Outpatient antimicrobial therapy with HITH is safe and effective in carefully selected cases of IE.
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Internal medicine journal · Jun 2013
Prevalence of depression in patients referred with snoring and obstructive sleep apnoea.
Depression and obstructive sleep apnoea are two common entities, with common symptoms that make identification of either condition difficult. Our aim was to examine, within a group of patients referred with snoring and obstructive sleep apnoea, (i) the prevalence of depression with the 14-question Hospital Anxiety and Depression Scale (HADS), (ii) the correlation between the two lead depression symptoms from the Mini-International Neuropsychiatric Interview (MINI) and HADS, and (iii) the relationship between depression symptoms with physiological markers of OSA. ⋯ Depending on classification, 32-53% of patients with snoring had depressive symptoms or were on treatment, which is significantly greater than the Australian average of 21%. A simplified depression questionnaire was validated. Severity of depression correlated with sleepiness and hypoxaemia but not with severity of sleep apnoea.
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Internal medicine journal · Jun 2013
Relationship between in-hospital location and outcomes of care in patients of a large general medical service.
The discrepancy between the number of admissions and the allocation of hospital beds means that many patients admitted under the care of a general medical service can be placed in other departments' wards. These patients are called 'outliers', and their outcomes are unknown. ⋯ Outlier patients had significantly shorter length of stay in hospital but significantly greater in-patient death rates. Surviving outlier patients had lower rates of readmission but lower rates of discharge summary completion.
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Population ageing is projected to impact on health services utilisation including Emergency Departments (ED), with older patients reportedly having a high rate of return visits. We describe and compare patterns in ED utilisation between older and younger adults, and quantify the proportion and rate of return visits. ⋯ Older patients are disproportionately represented among ED attendances. They also have an increasing propensity to re-present to ED, indicating a need to identify the clinical, social and health system-related risk factors for re-attendance by specific patients.