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Intern Med J [journal]
- Oxygen Prescribing Practice at Waikato Hospital does not meet guideline recommendations. [JOURNAL ARTICLE]
- Intern Med J 2014 Oct 15.
It is the recommendation of the British Thoracic Society oxygen guidelines and the Waikato Hospital prescribing policy that all supplemental oxygen should be prescribed. The aim of this audit was to evaluate the current oxygen prescribing practices on different specialty wards in the Waikato Hospital. The secondary aim was to evaluate potential harm from oxygen toxicity of the patients whose oxygen was not prescribed appropriately.120 inpatients receiving oxygen therapy were randomly selected between December 2012 and April 2013. Forty patients were selected from each of the respiratory, surgical and other medical subspecialty wards. Their medication charts, clinical records and laboratory results were reviewed regarding their oxygen prescription, smoking history, diagnoses of chronic respiratory diseases and previous documentation of Type 2 respiratory failure.In total 51.7% of all the patients audited had accurate oxygen prescriptions: 77.5 % of respiratory, 52.5% of surgical and 25% of other medical specialities. Among the 50 patients whose oxygen was not prescribed, many were classified as having high risk of potential complications of oxygen toxicity: 44% having known chronic respiratory disease, 70% having smoking history and 16% having previous Type 2 respiratory failure.Current oxygen prescription rates and practices in Waikato Hospital are not satisfactory and can in turn put patients at risk of oxygen toxicity. There is a significant discrepancy in prescribing practices between specialities. Better education of oxygen prescription is required to raise the awareness and to improve the prescribing practice across the hospital.
- Premature ejaculation during vaginal intercourse is not a male sexual dysfunction. [Letter]
- Intern Med J 2014 Oct; 44(10):1049.
- Author reply. [Letter]
- Intern Med J 2014 Oct; 44(10):1048.
- Cerebral screening in patients with hereditary haemorrhagic telangiectasia. [Letter]
- Intern Med J 2014 Oct; 44(10):1047.
- Organophosphate poisoning with coronary artery vasospasm confirmed by angiography. [Letter]
- Intern Med J 2014 Oct; 44(10):1043-6.
- Dermatomyositis and malignant melanoma: a rare association that worsens prognosis? [Letter]
- Intern Med J 2014 Oct; 44(10):1041-3.
- Calciphylaxis: fatal arteriosclerosis of uncertain mechanism. [Letter]
- Intern Med J 2014 Oct; 44(10):1040-1.
- Haploidentical peripheral blood stem cell infusion in combination with chemotherapy for acute myeloid leukaemia in elderly patients. [Journal Article]
- Intern Med J 2014 Oct; 44(10):1038-40.
Elderly patients with acute myeloid leukaemia (AML) have a poor prognosis with standard chemotherapy. Two elderly AML patients treated with infusion of family-derived partially human leukocyte antigen (HLA)-matched peripheral blood stem cells following each cycle of chemotherapy entered morphological complete remission without graft versus host disease or major toxicity. Our results support this as a non-toxic approach for inducing a graft versus leukaemia effect in patients not suitable for allogeneic transplantation. Additional resources required for donor assessment and harvest may be reduced by using banked partially HLA-matched mononuclear cells from unrelated donors.
- Prescribing for older people discharged from the acute sector to residential aged-care facilities. [Journal Article]
- Intern Med J 2014 Oct; 44(10):1034-7.
For frail older people, admission to hospital is an opportunity to review the indications for specific medications. This research investigates prescribing for 206 older people discharged into residential aged care facilities from 11 acute care hospitals in Australia. Patients had multiple comorbidities (mean 6), high levels of dependency, and were prescribed a mean of 7.2 regular medications at admission to hospital and 8.1 medications on discharge, with hyper-polypharmacy (≥10 drugs) increasing from 24.3% to 32.5%. Many drugs were preventive medications whose time until benefit was likely to exceed the expected lifespan. In summary, frail patients continue to be exposed to extensive polypharmacy and medications with uncertain risk-benefit ratio.
- Restless legs syndrome: an underappreciated and distressing problem for haemodialysis patients. [Journal Article]
- Intern Med J 2014 Oct; 44(10):1030-3.
Restless legs syndrome is a distressing condition that is more common in patients with end-stage renal failure. Despite the significant impact it has on quality of life and the documented association between restless legs syndrome and increased mortality, limited data regarding the epidemiology of restless legs syndrome in Australian dialysis patients are available. We report a prospective study that assessed the prevalence and factors associated with restless legs syndrome in an in-centre haemodialysis population.