Internal medicine journal
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Internal medicine journal · Oct 2023
Retrospective cohort study of hypersomnias of central origin from two Australian tertiary sleep disorders services.
Hypersomnias of central origin (HOCO) are diverse in origin and symptomatology and remain poorly described in an Australian population. We hypothesised that the rate of human leukocyte antigen (HLA) DQB1*0602 positivity in the Australian cohort would be comparable to international registries. ⋯ Patients with HOCO assessed in two specialised Australian clinics demonstrate comparable clinical characteristics to other published cohorts internationally; however, available pharmacological agents in Australia do not reflect international standards of care.
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Internal medicine journal · Oct 2023
Clinical outcomes amongst elderly patients with inflammatory bowel disease.
Inflammatory bowel disease (IBD) affects a growing cohort of elderly patients. Our aim was to compare the quality of care received by elderly patients with IBD with a nonelderly adult IBD population using clinical markers including steroid-free clinical remission. ⋯ Elderly patients with IBD were less likely to experience steroid-free clinical remission or be prescribed biologics. Elderly patients were less likely to receive education with respect to preventative medicine. The models of care for the elderly need re-evaluation and greater incorporation with the multidisciplinary IBD team.
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Internal medicine journal · Oct 2023
Germline mutations predispose New Zealand Māori to phaeochromocytoma/paraganglioma.
Phaeochromocytomas (PCC) and paragangliomas (PGL; together PPGL) are rare tumours of the adrenal medulla or extra-adrenal paraganglia. They may secrete catecholamines with significant cardiovascular effects. Management of PPGL is predominantly surgical, despite the anaesthetic risks related to potential haemodynamic instability. Meticulous pre-treatment and intra-operative management are required to improve cardiovascular outcomes. ⋯ Māori were over-represented due to high rates of germline SDHB R46Q mutations. There were few post-operative adverse outcomes in this contemporary cohort.
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Internal medicine journal · Oct 2023
Inconsistent discharge diagnoses for young cardiac arrest episodes: insights from a state-wide registry.
Administrative coding of out-of-hospital cardiac arrest (OHCA) is heterogeneous, with the prevalence of noninformative diagnoses uncertain. ⋯ Almost one third of diagnoses for young patients discharged after an OHCA included neither OHCA nor any underlying cause. Underestimating the burden of OHCA impacts ongoing patient and at-risk family care, data sampling strategies, international statistics and research funding.
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Internal medicine journal · Oct 2023
Observational StudyContribution of general medicine to perioperative and consultative care: an Australian metropolitan teaching hospital experience.
Little is known about the contribution of general medicine to perioperative and consultative care in Australia. A descriptive observational study was undertaken at a quaternary institution to evaluate the characteristics of perioperative and nonoperative consultations undertaken by general medicine. Results demonstrated patterns of engagement within a 'traditional' model of perioperative care and highlighted several opportunities for a redesign to a more proactive and collaborative cross-disciplinary model.