Internal medicine journal
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Internal medicine journal · Nov 2011
Oxygen administration and monitoring for ward adult patients in a teaching hospital.
The aims of this study were to describe oxygen administration and respiratory monitoring of ward patients in a tertiary teaching hospital, and to assess differences in characteristics and outcomes between patients who are receiving versus are not receiving oxygen. ⋯ Oxygen is administered to one-quarter of ward patients in our hospital. Oxygen saturation and RR are not documented in approximately 10% of patients. Oxygen therapy in ward patients identifies individuals with increased mortality. Continuing educational interventions to increase awareness of the high-risk status of these patients and strategies to detect patients at risk of hypoxaemia are needed.
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Internal medicine journal · Oct 2011
Safety of withholding anticoagulation in patients with mechanical prosthetic valves and intracranial haemorrhage.
Patients with prosthetic heart valves require lifelong anticoagulation to prevent thromboembolism. When they have intracranial haemorrhage, anticoagulation has to be withheld. This study was aimed to identify safety duration and complications of anticoagulation withholding in patients with prosthetic heart valves and intracranial haemorrhage. ⋯ One patient had right basal ganglia infarction after 7 days of anticoagulation withholding. Prosthetic heart valve dysfunction was suspected in one patient who withheld anticoagulant for 76 days. Discontinuation of anticoagulation in patients with prosthetic heart valves and intracranial haemorrhage for less than 7 days was associated with low thromboembolic risk and there was no clinical evidence of prosthetic heart valve dysfunction when anticoagulation was withheld for less than 14 days.
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Internal medicine journal · Oct 2011
An invasive management strategy is associated with improved outcomes in high-risk acute coronary syndromes in patients with chronic kidney disease.
Chronic kidney disease (CKD) is associated with poor outcomes after acute coronary syndromes, yet selection for invasive investigation and management is low. ⋯ In patients with CKD after STEMI/NSTEACS, 6-month mortality and morbidity is high, selection for angiography is lower, yet angiography is associated with a reduced long-term mortality, and with comparable revascularization rates to those without CKD. In-hospital AKI is more common in CKD and predicts a high 6-month mortality.