Internal medicine journal
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Internal medicine journal · Jan 2024
Statement of the Rehabilitation Medicine Society of Australia and New Zealand for the therapeutic use of botulinum toxin A in spasticity management.
The Rehabilitation Medicine Society of Australia and New Zealand advocates the safe, effective and evidence-based use of botulinum toxin type A for spasticity management. The process requires appropriate training, alongside considerable knowledge and skills, to maximise efficacy. The processes before and after injection contribute to effectiveness. ⋯ The patient and/or carers are considered part of the decision-making team. Postinjection therapy and measurement of goal achievement are highly recommended as part of the wider holistic approach to management. The Society believes treatment failures can be minimised by following clear clinical guidelines.
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Internal medicine journal · Jan 2024
Telemedicine in Specialist Outpatient Care during COVID-19: A Qualitative Study.
COVID-19 accelerated healthcare changes, introducing various telehealth services. Work is needed to determine the suitability of telemedicine in the post-pandemic era. ⋯ Despite expressing some concerns over its limitations, patients valued telemedicine for its convenience and for meeting their needs during the pandemic. While acknowledging that patients experienced some benefits from telemedicine, clinicians expressed concerns about potential missed diagnoses, uncertain clinical outcomes and lack of administrative and technological infrastructure. The ultimate test of telemedicine will be its impact on clinical outcomes versus longstanding models of in-person care.
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Internal medicine journal · Jan 2024
Thrombo-inflammatory response in hospitalized patients with COVID-19; a single institution experience.
Severe COVID-19 causes acute inflammation, which is complicated by venous thromboembolism events (VTE). However, it is unclear if VTE risk has evolved over time since the COVID-19 outbreak. ⋯ We observed lower rates of VTE compared to the internationally reported rate for the same period. We conclude that in the setting of controlled hospital admission rate and standard anticoagulation guidelines, COVID-19 resulted in similar thrombo-inflammatory response and VTE rates over the first 1.5 years of the pandemic.
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Internal medicine journal · Jan 2024
Pleural procedures: An audit of Practice and Complications in a Regional Australian Teaching Hospital.
Pleural procedures are essential for the investigation and management of pleural disease and can be associated with significant morbidity and mortality. There is a lack of pleural procedure complication data in the Australian and New Zealand region. ⋯ Complication rates for pleural procedures performed by respiratory specialist trainees at Wollongong Hospital are comparable with international outcomes. This audit provides data for comparison on pleural procedure complication rates in Australia. Future studies are required to determine complication rates with IPCs.
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Internal medicine journal · Jan 2024
Rheumatology specialist care delivered at the Southern QLD Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care.
There is limited literature on the prevalence of rheumatologic conditions in Australian First Nations people. Existing evidence suggests a high disease burden with poorer outcomes. In 2016 a rheumatology clinic was established at The Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (CoE). ⋯ Provision of rheumatology specialty care in an urban primary health setting aimed specifically at the needs of First Nations people led to increased uptake and engagement. A broad range of rheumatologic diagnoses was made and significant DMARD treatments commenced.