Internal medicine journal
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Internal medicine journal · May 2023
Review Meta AnalysisOne-Minute Preceptor and SNAPPS for clinical reasoning: a systematic review and meta-analysis.
Clinical reasoning teaching strategies could be important models to teach healthcare trainees. This study aims to assess the effectiveness of clinical reasoning teaching strategies (one-minute preceptor (OMP) and SNAPPS) for developing clinical reasoning skills, attitudes and satisfaction of medical/healthcare students and post-graduate trainees as compared to controls. A systematic review and meta-analysis of randomised controlled studies, with no restriction on language or publication date, were carried out by searching the PubMed, SCOPUS, ERIC, Web of Science, Embase and Cochrane Library databases. ⋯ The strategies for teaching clinical reasoning improved the performance of healthcare students and professionals on this skill, promoting deeper discussion of clinical cases and a higher number of differential diagnoses. Further good-quality trials are needed to corroborate these findings. PROSPERO Registration: CRD42020175992.
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Since the recognition of BRAF V600E mutations in the majority of cases of hairy cell leukaemia, Erdheim-Chester disease and Langerhans cell histiocytosis, the targeted oral kinase inhibitors dabrafenib and vemurafenib have been adapted for their treatment. Like other targeted agents, these drugs produce high response rates and predictable but unique side effects. Physician familiarity is essential for the effective use of these agents. We review the Australian experience of BRAF/MEK inhibitor therapy in these rare haematological cancers.
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Internal medicine journal · May 2023
Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case-control study.
Colorectal adenocarcinoma is an important and preventable complication of inflammatory bowel disease (IBD). A previous case series suggested mental health issues and poor engagement in care as novel risk factors. ⋯ This study confirms poor adherence or engagement with care as a new risk factor for colorectal adenocarcinoma in patients with IBD; identifying a vulnerable group whom clinicians should endeavour to engage in order to avoid this catastrophic complication.
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Internal medicine journal · May 2023
Impact of a pharmacist led thiopurine monitoring service in outpatients with inflammatory bowel disease.
Thiopurines are effective therapies for inflammatory bowel disease (IBD); however, treatment comes with safety concerns and adverse effects. Knowledge of the impact of pharmacists performing thiopurine monitoring is limited. ⋯ Pharmacist monitoring of thiopurine therapy initiation in IBD outpatients improves adverse effect monitoring and increases medication persistence.