Internal medicine journal
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Internal medicine journal · Nov 2010
Multicenter Study Comparative StudyExploratory study of the 'weekend effect' for acute medical admissions to public hospitals in Queensland, Australia.
To determine whether in-hospital deaths of patients admitted through emergency departments with acute exacerbations of chronic obstructive pulmonary disease (COPD), acute myocardial infarction, intracerebral haemorrhage and acute hip fracture are increased by weekend versus weekday admission (the 'weekend effect'). ⋯ This is the first Australian study on the 'weekend effect' (in a cohort other than neonates), and the first study worldwide to assess specifically the weekend effect among COPD patients. Observed patterns were consistent with overseas research. There was a significant weekend effect for myocardial infarction. Further research is needed to determine whether location (e.g. rural), clinical (e.g. disease severity) and service provision factors (e.g. access to invasive procedures) influence the weekend effect for acute medical conditions in Australia.
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Internal medicine journal · Nov 2010
Comparative StudyImpact of troponin 1 on long-term mortality after emergency orthopaedic surgery in older patients.
To determine the association between post-operative troponin rises and longer term (2-year) mortality after emergency orthopaedic surgery in patients over 60 years of age. ⋯ Elevated post-operative troponin levels are predictive of 1-year but not 2-year mortality in older patients undergoing emergency orthopaedic surgery.
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Internal medicine journal · Nov 2010
Comparative StudyScreening for hepatitis B in East Arnhem Land: a high prevalence of chronic infection despite incomplete screening.
Infection with hepatitis B virus (HBV) is common in Aboriginal Australians, but current seroprevalences in Northern Territory communities are unknown. We performed an audit of HBV serology on a convenience sample of 112 adults at an East Arnhem Land Health Service. ⋯ Evidence of HBV exposure (core antibody-positive) was found in 43 of 68 (63%) patients tested, and current HBV infection (surface antigen-positive) was found in nine of 76 (12%). HBV is an incompletely defined, under-resourced and substantial public health problem in Aboriginal Australians.
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Sudden cardiac death due to ventricular arrhythmias remains the most common cause of death in developed nations. Implantable cardioverter defibrillators have been shown to improve mortality in high-risk groups for ventricular tachyarrhythmias, but they are not curative, with the risk of arrhythmia recurrence remaining unaltered. ⋯ Recent advances in catheter ablation for VT have increased the efficacy in creating adequate lesions, accurate three-dimensional maps and mapping haemodynamically unstable VT, all of which have increased the utility of this modality in the treatment of ventricular arrhythmias. In this article, we review the recent advances that have fuelled renewed interest in catheter ablation of VT, its clinical utility and who should be referred.