Internal medicine journal
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Internal medicine journal · Feb 2025
Post-colonoscopy colorectal cancer in the Western Australian population: analysis of patient, histopathological and molecular characteristics.
Post-colonoscopy colorectal cancer (PCCRC), defined as colorectal cancer (CRC) detected after a cancer-negative colonoscopy, represents a key quality indicator for CRC detection and prevention. While most PCCRC is attributed to missed lesions, few studies examine pathologic and molecular characteristics of PCCRC to assess for possible de novo cancer formation causing PCCRC. ⋯ A significant percentage of PCCRC occurred despite adequate prior colonoscopy. Missed sessile serrated lesions may contribute to many of these cases; however, further studies are required to examine possible de novo cancer as a cause of PCCRC that may involve unique biological pathways.
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Internal medicine journal · Feb 2025
'Charge what you think you're worth': a qualitative study exploring the gender pay gap in medicine and the role of price transparency.
The gender pay gap in medicine is entrenched and has a negative impact on economic growth, institutional reputation and financial success, recruitment, retention and job satisfaction of female specialists and patient care. It also discourages women from entering specialist fields of medicine. In the Australian unregulated market setting, female specialists are not simply getting paid less, they are choosing to set lower fees than their male counterparts. ⋯ The gender pay gap is pervasive. Greater transparency on fees and quality could be explored as a potential solution to reduce pay inequality.
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Internal medicine journal · Feb 2025
Is Australia ready for the rollout of amyloid-targeting therapies for Alzheimer's disease? Results from a national survey characterising current infrastructure capability, workforce and training needs of memory and cognition clinics.
New amyloid-targeting monoclonal antibody (mAb) therapies for Alzheimer's disease (AD) are currently under review by the Therapeutic Goods Administration for use in Australia. ⋯ Australia's health system preparedness for amyloid-targeting mAb therapies will require further investment in infrastructure, equity of access, clinician training and support. Long wait times already impact access to clinics, and with the forecast rise in MCI and dementia cases, services will need to be expanded, and appropriate Models of Care and clear and efficient inter-sector health pathways will be needed to prepare for the use of mAbs.
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Internal medicine journal · Feb 2025
The impact of obstructive sleep apnoea on post-operative outcomes.
Unrecognised obstructive sleep apnoea (OSA) has been associated with adverse cardiorespiratory perioperative outcomes. However, with changing anaesthetic and perioperative management, there is ongoing uncertainty about the importance of OSA as a risk factor for post-operative complications. ⋯ Unrecognised OSA was not associated with an increase in clinically evident cardiorespiratory complications in this cohort. The lower complication rates compared with earlier studies suggest that increased use of less invasive surgical techniques, improved pain management and increased awareness of OSA have had an impact in reducing postoperative complications in this group. Further research is needed to clarify the impact of severe OSA on post-operative outcomes in different surgical cohorts with varying risk profiles in order to develop optimal perioperative pathways.
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This article considers claims to ownership over genomic data and implications for data sharing and research. There are various arguments for vesting ownership in individuals, but little supporting authority. However, policies such as privacy law and informed consent provide alternative methods of protecting individuals. The conclusions highlight the importance of clear channels of communication with patients.