Internal medicine journal
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Internal medicine journal · Jun 2023
ReviewPlerixafor use in New Zealand 2016-2019: An Observational Study.
Plerixafor is used to mobilise CD34-positive stem cells for autologous transplantation to treat haematological malignancy. Funded in New Zealand since 2016, plerixafor can be used 'pre-emptively' to salvage a failing first attempt or as a 'rescue' strategy involving re-mobilising after 4 weeks. The rate of failed mobilisation and plerixafor uptake in New Zealand is not known, while international practice varies widely. ⋯ Plerixafor strategies in New Zealand allow successful stem cell mobilisation for ≥96% of patients. Further research is required to investigate whether increased use would be cost-effective through reduced chemotherapy and apheresis duration, and improved graft quality.
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Internal medicine journal · Jun 2023
ReviewContemporary updates on ventricular arrhythmias: From mechanisms to management.
Ventricular arrhythmias (VAs) are a group of heart rhythm disorders that can be life-threatening and cause significant morbidity. VA in the presence of structural heart disease (SHD) has distinct prognostic implications and requires a comprehensive and multifaceted approach for investigation and management. Early specialist referral should be considered for all patients with VA. ⋯ Whilst commonly used and well-established, antiarrhythmic drugs can be hampered by toxicity and failure of adequate arrhythmia control. Catheter ablation is increasingly being considered a feasible first-line alternative to medical therapy, where outcomes are influenced by disease aetiology and scar burden in SHD. Catheter ablation is associated with reduced arrhythmia recurrence and burden and improved quality of life at follow-up.
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Internal medicine journal · Jun 2023
Multicenter Study Observational StudyPatient-reported Experience Measures in Deprescribing for Hospitalised Older Patients: A Prospective, Multicentre, Observational Study.
Hospitalisation provides an opportunity for medication review and deprescribing. Patient-reported experience measures (PREM) for deprescribing in older patients in hospital are not well described. ⋯ These PREM are a feasible tool to examine older patients' experiences of deprescribing in hospital and might be applied to evaluate interventions to improve awareness, shared decision-making and provision of information when deprescribing for older patients.
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Internal medicine journal · Jun 2023
Observational StudyActivity and Outcomes of Autologous Stem Cell Transplantation in the Private Sector in Australia.
Few Australasian autologous stem cell transplantation (ASCT) programmes perform ASCT in the private sector. Relatively little is known about ASCT outcomes in the private sector, which varies in care delivery models to the public system. ⋯ We report excellent OS and low TRM, demonstrating the critical role of the private sector in the administration of this highly complex therapy. The Icon ASCT programme is the largest ASCT contributor in Queensland. It is inclusive of patients aged ≥70 years, demonstrating low and acceptable TRM.
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Internal medicine journal · Jun 2023
Comparative StudyUtilisation of immunoglobulin in New Zealand.
Immunoglobulin is an expensive and scarce resource and usage is increasing worldwide. Immunoglobulin is used to treat a variety of clinical conditions, particularly primary and acquired immunodeficiencies and immune-mediated neurological disorders. As immunoglobulin usage continues to increase, plasma collection must increase accordingly in order to sustain immunoglobulin production. The New Zealand Blood Service (NZBS) is the provider of immunoglobulin in New Zealand (NZ). Information regarding national immunoglobulin usage warrants analysis given the rise in usage. ⋯ Immunoglobulin is a strategic resource and appropriate usage is critical to regulate demand.