Abstract:
BACKGROUND:Cancer treatment near end of life is not likely to add meaningful benefit and minimising intervention rates has been promoted as an indicator of quality of care. Population-based analysis of treatment allows comparative analysis of treatment rates and provides insight into patterns of care. AIMS:To report a population-based analysis of both radiotherapy and active systemic therapy (AST) delivery rates along with patterns of treatment within the last 14 and 30 days of life. METHODS:The Evaluation of Cancer Outcomes Registry records clinical information on all newly diagnosed cancer patients for the Barwon South West Region of Victoria, Australia. Diagnosis details, tumour type and stage as well as core treatment details and date of death were extracted for all patients diagnosed from 2009 to 2015 inclusive. RESULTS:A total of 12 760 cases cancers were recorded. The median age of all cases was 68.8, and 53% were male. AST was received by 3699 (29%) of patients and radiotherapy by 3811 (30%). Patient deaths within 14 and 30 days of treatment for AST were 4.3 and 8.7%, respectively, and deaths within 14 and 30 days of treatment for radiotherapy 3.8 and 8.0% respectively. Factors associated with death within 30 days of AST and/or radiotherapy were male gender, age greater than 70 years and higher disease stage (all P < 0.01). Treatment rates within 30 days of death were highest for lung cancer (23% of cases) and lowest for breast cancer (2% of cases). CONCLUSIONS:This population-based analysis of AST and radiotherapy treatment within the last 30 days of life within a region of Australia has shown overall treatment rates below 10%. Treatment rates appear influenced by both patient and tumour characteristics. Future focus on subgroups with high rates of late intervention may help minimise treatment unlikely to add benefit.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Pitson G,Matheson L,Garrard B,Eastman P,Rogers Mdoi
10.1111/imj.14377subject
Has Abstractpub_date
2020-05-01 00:00:00pages
596-602issue
5eissn
1444-0903issn
1445-5994journal_volume
50pub_type
杂志文章abstract::The phenomenon of addiction is complex, although its expression clinically is relatively straightforward. There is a series of neurophysiological changes that mediate changes in the mesolimbic and mesocortical systems which in turn lead to disturbances in reward mechanisms. These then act to perpetuate the cycle of in...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2007.01350.x
更新日期:2007-05-01 00:00:00
abstract::The incidence and prevalence of autoimmune diseases such as rheumatoid arthritis, primary Sjögren syndrome, scleroderma and systemic lupus erythematosus (SLE) varies with geography and ethnicity. For example, SLE is reported to be more common in populations such as African-Caribbeans and Indigenous Australians (IA). A...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12039
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Advanced training in gastroenterology currently consists of 2 years of core training and 1 elective (non-core) year. We surveyed gastroenterologists 2-7 years following completion of training to determine the strengths and weaknesses of their training. METHODS:All gastroenterologists were invited to partici...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2012.02757.x
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemoradiation therapy (CRT) is standard of care treatment for locally advanced rectal cancer (LARC). A pathologic complete response (pCR) following CRT is an early indicator of treatment benefit and associated with excellent survival outcomes. As capecitabine replaces infusional 5-fluorouracil (...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.15045
更新日期:2020-09-08 00:00:00
abstract:BACKGROUND:Stroke is an Australian health priority area causing considerable levels of disability. We report 90-day outcomes for a cohort of acute stroke patients in New South Wales (NSW), Australia prior to randomization to a large cluster randomized controlled trial (CRCT), the Quality in Acute Stroke Care (QASC) tri...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02330.x
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND: Hepatic epithelioid haemangioendothelioma (HEH) is a rare, low grade malignant neoplasm of endothelial origin which is difficult to diagnose and has a variable outcome. We review five HEH cases from our centre with the aim of identifying clinical predictors of outcome and various therapeutic options. METH...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2009.02043.x
更新日期:2010-10-01 00:00:00
abstract::Decompressive hemicraniectomy (DHC) has been shown to reduce mortality in malignant middle cerebral artery (MCA) infarction. Our primary objective was to compare 1-year mortality between patients receiving DHC for malignant MCA infarction at our institution based on hospital of origin. We retrospectively reviewed the ...
journal_title:Internal medicine journal
pub_type: 杂志文章,meta分析
doi:10.1111/imj.14050
更新日期:2018-10-01 00:00:00
abstract::The differential diagnosis of Parkinsonian syndromes is challenging, especially in the elderly as they often have complex presentations. Nuclear imaging modalities can increase diagnostic accuracy. Single-photon emission tomography (SPECT) using the ligand (99m Tc)-TRODAT-1 is used overseas but is yet to be approved i...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14017
更新日期:2018-09-01 00:00:00
abstract::The Australian National Chronic Obstructive Pulmonary Disease (COPD) guidelines recommend that inhaled corticosteroids (ICS) be reserved for patients with a post-bronchodilator forced expiratory volume in 1 s (FEV1 ) less than 50% predicted and those who experience ≥2 exacerbations in 12 months. In total, 707 COPD pat...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13611
更新日期:2017-11-01 00:00:00
abstract::A cross-sectional survey of 265 adult patients with haematological malignancy, haemoglobinopathy or human immunodeficiency virus was performed to determine the potential risk of infection from animal exposures. One hundred and thirty-seven (52%) owned an animal; the majority were dogs (74%) and cats (39%), but 14% own...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13361
更新日期:2017-03-01 00:00:00
abstract:AIMS:To survey the practice among gastroenterologists in Australia relating to screening for latent infections and vaccination of patients with inflammatory bowel disease prior to treatment with tumour necrosis factor alpha (TNF-α) inhibitors. METHODS:A structured 15 question electronic survey was advertised to gastro...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2009.02114.x
更新日期:2011-06-01 00:00:00
abstract::Mitochondrial DNA (mtDNA) haplogroups are 'neutral polymorphisms' in the mtDNA genome, which have accumulated and persisted along maternal lineages as the human population has migrated worldwide. Three ethnically distinct lineages of human mtDNA populations have been identified: European, characterized by nine haplogr...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01118.x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. AIM:To describe the spectrum of illn...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13993
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Medical school and resident training programmes offer different learning opportunities and outcomes. The aim of the study was to assess medical student and intern experience in common clinical procedures. METHODS:Interns employed in a metropolitan teaching hospital from 2000 to 2004 completed a survey of ex...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2009.01699.x
更新日期:2009-04-01 00:00:00
abstract:AIM:To explore and detail clinical experiences of dabigatran, a novel anticoagulant, after it became available in New Zealand in July 2011. METHODS:A cohort of patients was recruited from Hutt Hospital and the two largest primary care practices in the Hutt Valley region. They were included if they took at least one do...
journal_title:Internal medicine journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/imj.12370
更新日期:2014-03-01 00:00:00
abstract::Leprosy remains an important global health concern, but little has been published about its diagnosis and management in developed settings. It has been postulated that delay in diagnosis is common in developed settings. We reviewed all the cases of leprosy seen at a major tertiary referral centre between 1999 and 2013...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12638
更新日期:2015-01-01 00:00:00
abstract::We describe three patients with severe refractory cutaneous polyarteritis nodosa, resulting in painful ulcers involving the lower limbs and causing toe necrosis. Due to the severity of the cutaneous manifestations, the three patients received intravenous immunoglobulins at a dose of 1 g/kg/day for 2 days monthly. Afte...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2012.02739.x
更新日期:2012-04-01 00:00:00
abstract::There is accumulating evidence that point-of-care delivery of clinical information such as evidence-based medicine, practice guidelines and drug information can streamline clinical practice and reduce preventable errors. In Australia, hospital-based physicians have -generally been slow to fully use these resources to ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1046/j.1445-5994.2003.00465.x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Stroke neurologists, vascular surgeons, interventional neuroradiologists and interventional cardiologists have embraced carotid angioplasty and stenting (CAS) because of potential advantages over carotid endarterectomy (CEA). At Austin Health, a multidisciplinary neuro-interventional group was formed to stan...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02285.x
更新日期:2011-11-01 00:00:00
abstract::A patient with pulmonary arterial hypertension secondary to systemic sclerosis was successfully treated with sitaxentan prior to its worldwide withdrawal (because of hepatotoxicity concerns), but then ironically experienced acute hepatic dysfunction during substitute bosentan therapy, and was eventually stabilised on ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.12007
更新日期:2012-12-01 00:00:00
abstract::Chronic lead exposure is recognized as a potential cause of hyperuricaemia, kidney damage and hypertension. The fascinating story of lead poisoning and nephrotoxicity illustrates the utility of descriptive studies in the early elucidation of a new disease entity. The pursuit towards understanding lead nephropathy is p...
journal_title:Internal medicine journal
pub_type: 历史文章,杂志文章
doi:10.1111/j.1445-5994.2006.01181.x
更新日期:2006-10-01 00:00:00
abstract::Imatinib mesylate (IM) is currently used as the first therapeutic choice against chronic myelogenous leukaemia (CML). Because IM poorly penetrates the blood-brain barrier, IM-treated CML patients may have a potential risk of central nervous system (CNS) involvement. Here we report a case with lymphoid blast crisis iso...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2009.01947.x
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Escalating morbidity and mortality associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major health burden in Australia, particularly among migrants from endemic areas who may present late. METHODS AND AIMS:We evaluated the knowledge and educational needs of general pr...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2011.02440.x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND/AIM:Families, especially in Chinese society, play a crucial role in care provision for relatives with schizophrenia, but the burden of caregiving has shown to cause significant distress among caregivers. The aim of the study is to assess the degree of stress and burden among caregivers of relatives with schi...
journal_title:Internal medicine journal
pub_type: 杂志文章,多中心研究
doi:10.1111/imj.14166
更新日期:2019-03-01 00:00:00
abstract::The indication for permanent pacemaker remains controversial in malignant neurocardiogenic syncope. A highly reproducible prolonged pause during a repeat head-up tilt-table testing may identify a subgroup of neurally mediated syncope with a prominent and consistent cardioinhibitory component. Seven patients (3 females...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1444-0903.2004.00626.x
更新日期:2004-08-01 00:00:00
abstract::Healthcare encompasses multiple discourses to which health professionals, researchers, patients, carers and lay individuals contribute. Networks of patients and non-professionals often act collectively to build capacity, enhance access to resources, develop understanding and improve provision of care. This article exp...
journal_title:Internal medicine journal
pub_type: 历史文章,杂志文章
doi:10.1111/imj.14426
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:In 2004, the Pharmaceutical Benefits Scheme (PBS) listed infliximab as a subsidised treatment for ankylosing spondylitis (AS). Eligibility to receive this treatment for AS involved fulfilling several criteria. AIM:To examine the medical literature concerning response to tumor necrosis factor (TNF)-alpha inh...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2006.01004.x
更新日期:2006-02-01 00:00:00
abstract::Depression, ischaemic heart disease and cerebrovascular disease are important causes of morbidity and are among the leading contributors to global health burden. These conditions often occur in the same patient, resulting in considerably greater effect on health than combinations of chronic diseases without depression...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2008.01794.x
更新日期:2009-01-01 00:00:00
abstract::Neuroimaging in dementia has focused on documenting any burden of vascular disease or excluding any reversible intracranial pathology. We review the use of computed tomography to examine for medial temporal lobe atrophy in dementia and compare this with a case series of such measurements from our memory clinic. Measur...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2007.01598.x
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The parenteral administration of oestradiol acutely protects against exercise-induced myocardial ischaemia in women, but whether this effect is sex-specific is not known. AIMS:The effects of acutely administered conjugated equine oestrogen on exercise-induced myocardial ischaemia in men with established cor...
journal_title:Internal medicine journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1445-5994.2003.00346.x
更新日期:2003-05-01 00:00:00