Internal medicine journal
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Internal medicine journal · Mar 2020
Management of patients with gout and achievement of target serum urate levels at a tertiary rheumatology service in Australia.
Gout is common crystal arthritis that is often managed sub-optimally. ⋯ Despite effective therapy the number of patients treated for gout at a large public metropolitan teaching hospital reaching SU target was low. Almost one-quarter of patients in the study discontinued contact with the clinic. The reasons for this are not clear and are likely multifactorial.
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Internal medicine journal · Mar 2020
James Cook's first Pacific voyage: alleged scurvy-freedom unmasked.
The east coast of New Holland was discovered 250 years ago during a voyage of covert strategic exploration of the Pacific Ocean regions by Lieutenant James Cook acting under instructions of the Royal Navy espionage chief, Philip Stephens, Secretary of the Admiralty. In addition to the study of the transit of Venus, the well resourced mission included some clandestine mapmaking during August 1768 to July 1771. Tasked by the Royal Society of London to investigate the anti-scorbutic effects of a variety of foods and herbs, Cook's post-operational debrief to the Admiralty included the inaccurate supposition that HM Bark Endeavour's cruise was scurvy-free. Why did Cook extend deceptive cartographic practices deliberately to conceal the apparent failure of the anti-scorbutic comestibles?
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Internal medicine journal · Mar 2020
ReviewNew advances in the management of cytomegalovirus in allogeneic haemopoietic stem cell transplantation.
Cytomegalovirus (CMV) viraemia continues to be a frequent complication in the post-haemopoietic stem cell transplantation period despite a low incidence of CMV end-organ disease. Several significant advances in the understanding and management of CMV infection have occurred in the last few years including improved diagnostics, monitoring of CMV immunity, availability of novel anti-CMV drugs, and emerging use of immunotherapies including CMV-specific T-cell infusions. In addition to reviewing these advances we also explore some of the more practical prescribing issues of the older and newer CMV drugs including cost, toxicity and drug interactions to help clinicians navigate this new era of CMV management.
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Internal medicine journal · Mar 2020
Neoadjuvant chemotherapy in non-metastatic breast cancer: a study on practice trends in a regional cancer treatment service.
Neoadjuvant chemotherapy (NACT) is increasingly used for managing locally advanced and high risk non-metastatic breast cancer. ⋯ NACT is increasingly used in the Regional Cancer Treatment Service, with improving compliance to practice recommendations. These results are reassuring and can be used to help patients develop a realistic expectation towards NACT.