Internal medicine journal
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Internal medicine journal · Oct 2023
Willingness to be tested for a secondary cause of hypertension: a survey of the Australian general community.
Primary aldosteronism (PA) represents the most common and potentially curable cause of secondary hypertension. However, PA is not commonly screened for, and up to 34% of patients who screen positive do not complete the full diagnostic process. This suggests that the diagnostic process may pose a barrier to patients and may contribute to the under-diagnosis of PA. ⋯ A high proportion of patients are willing to engage in testing for a secondary cause of hypertension. Education about the risks associated with hypertension and the testing process may overcome several barriers to testing.
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Internal medicine journal · Oct 2023
CommentFibrillary and immunotactoid glomerulopathies in the Hunter region: a retrospective cohort study.
Fibrillary (FGN) and immunotactoid (IT) glomerulonephritis are uncommon. ⋯ FGN is rare, with poor response to immunomodulatory therapy. It carries poor renal prognosis. Less proteinuria at diagnosis may predict a more benign disease course. IT is associated with haematological malignancy and carries better prognosis and response to treatment.
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Internal medicine journal · Oct 2023
CommentUpdate on the management of first episode primary spontaneous pneumothorax in an Australian hospital network.
International guidelines and recent research favour a less interventional approach to primary spontaneous pneumothorax (PSP). A retrospective clinical audit of 68 first-episode PSP was undertaken at a major tertiary teaching hospital network in Melbourne, Australia, found that most patients presenting with a moderate to large pneumothorax received initial intercostal catheter insertion (56%), though many (81%) would have met criteria for consideration of conservative management. The results suggest continued deviation from clinical guidelines in the management of PSP.
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Internal medicine journal · Oct 2023
Anti-tumour necrosis factor-induced skin rashes in inflammatory bowel disease: a systematic review and evidence-based management algorithm.
Anti-tumour necrosis factor alpha (anti-TNF) agents are a highly effective treatment for inflammatory bowel disease (IBD). Skin lesions, including psoriasiform, eczematous and lupoid eruptions, may paradoxically result from anti-TNF use and cause significant morbidity leading to discontinuation of therapy. There are no consensus guidelines on the management of these lesions. ⋯ Assessment of anti-TNF skin lesions should be performed in conjunction with a dermatologist and rheumatologist in complex cases. High-quality prospective studies are needed to clarify the validity of these algorithms in the future.
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Globalisation has increased human movements around the world, spurring greater connectiveness and opportunities to collaborate. In an increasingly connected world, quality assurance among professionals is paramount, particularly in medical research where PhD (Doctor of Philosophy) degree holders are expected to be at the peak of their field and play advanced-level research, education and leadership roles. While some regional efforts have been made to ensure comparability in the standards of advanced degree training, no previous study has compared these standards for a PhD in medicine across the globe. ⋯ Harmonisation of medical PhD degrees through international standards should be considered to encourage quality improvement and benchmarking between institutions, as well as to facilitate greater ease of movement within the medical research community, improving international collaboration and individual career opportunities accordingly.