Internal medicine journal
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Internal medicine journal · Apr 2023
Treatment of Patients with Waldenström Macroglobulinaemia: Clinical practice update from the Myeloma Foundation of Australia Medical and Scientific Advisory Group.
Waldenström macroglobulinaemia (WM) is an indolent B-cell malignancy characterised by the presence of IgM paraprotein, bone marrow infiltration by clonal small B lymphocytes with plasmacytic differentiation and the MYD88 L265P mutation in >90% of cases. Traditionally, WM has been treated with chemoimmunotherapy. ⋯ There is emerging evidence on the use of other agents including B-cell lymphoma 2 inhibitors and on the treatment of rare presentations of WM. In this update, the Medical and Scientific Advisory Group of Myeloma Australia reviews the available evidence on the treatment of WM since the last publication in 2017 and provides specific recommendations to assist Australian clinicians in the management of this disease.
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Internal medicine journal · Apr 2023
Prospective associations between pain at multiple sites and falls among community-dwelling older Australians.
Pain at multiple sites is prevalent among older people. However, studies investigating the relationship between pain and falls focus largely on single-site pain. ⋯ Falls risk should be ascertained for older people with pain, irrespective of whether they present with a single or multiple sites pain. Nevertheless, older adults with multisite pain may require additional attention as they appear to have a significantly elevated risk of multiple falls.
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Internal medicine journal · Apr 2023
Observational StudyMissed diagnosis or misdiagnosis: How often do hospitalised patients with a diagnosis of chronic obstructive pulmonary disease (COPD) have spirometry that supports the diagnosis?
Chronic obstructive pulmonary disease (COPD) is one of the most common clinical diagnoses among hospital inpatients. Diagnosis requires the demonstration of post-bronchodilator airflow obstruction. However, it is uncertain how often spirometry results are available at the time a diagnostic label of COPD is applied. ⋯ Inpatients with a clinical diagnosis of COPD frequently did not have supportive spirometry results that confirmed the diagnosis or had results inconsistent with COPD. Misdiagnosis and inappropriate prescribing require further attention to improve the quality of care in this setting.
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Internal medicine journal · Apr 2023
Observational StudyA Comprehensive Study of the Epidemiology of Haematological Malignancies in North Queensland.
There is an absence of clinically relevant epidemiological data in regional Australia pertaining to haematological malignancies. ⋯ The present study successfully reports on the incidence of haematological malignancies in regional Queensland using a clinically meaningful diagnostic classification system and identifies potential geographic hotspots. We advocate for such contemporary, comprehensive and clinically meaningful epidemiological data reporting of blood cancer diagnoses in wider Australia. Such an approach will have significant implications towards developing appropriate data-driven management strategies and public health responses for haematological malignancies.
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Internal medicine journal · Apr 2023
Survey of treatment practices for immunocompromised patients with COVID-19 in Australasia.
Coronavirus disease 2019 (COVID-19) in immunocompromised patients can lead to severe and prolonged illness. Data are limited with regard to management of COVID-19 in this setting, particularly in persistent or recrudescent infection. The authors conducted an online survey among infectious diseases doctors to determine current approaches to treatment across Australasia. There was marked variability in responses relating to the diagnostic modalities and use of antiviral agents in patients with immunocompromise, highlighting the need for high-quality studies to guide treatment decisions in this group.