Internal medicine journal
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Internal medicine journal · Mar 2023
Putting the best foot forward when treating newly diagnosed multiple myeloma.
Multiple myeloma (MM) remains an incurable disease. In Australia, patients receive sequential lines of novel agent (NA)-based lines of therapy (LOTs), including proteasome inhibitors, immunomodulatory drugs and CD38-targeting monoclonal antibodies within the constraints of the pharmaceutical benefits scheme. We propose that induction with a quadruplet incorporating all three drug classes and dexamethasone at diagnosis is the best approach to gain disease control.
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Internal medicine journal · Mar 2023
My Health Record (and E-scripts): essential new resource for physicians-a personal perspective.
From a personal perspective of an endocrinologist in private practice: Integration of the My Health Record into everyday clinical practice is time- and cost-saving, allows for more accurate record keeping and most importantly improves overall patient care. The main deficiency at present is incomplete uptake by medical specialists in private and public practice, as well as pathology and imaging service providers. We will all reap the benefits as these entities become engaged and contribute towards making this electronic medical record truly universal.
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Internal medicine journal · Mar 2023
Meta AnalysisPrevalence and clinical risk prediction of hypertriglyceridaemia in a community cohort.
Hypertriglyceridaemia (HTG; defined as ≥1.7 mmol/L) has a prevalence of 18-33% with significant inter-regional variation. Despite meta-analysis demonstrating its association with increased risk of cardiovascular disease, only 40% of HTG is identified in the community resulting in underutilisation of lipid-lowering therapy and specialist clinics. An increase in awareness of its clinical risk factors is needed to improve the identification and management of HTG to prevent cardiovascular risk. ⋯ HTG ≥1.7 mmol/L is common, affecting 24% of the HCS. Clinical predictors identify modifiable risk factors for cardiovascular risk management. Clinician education to promote awareness is required to improve patient outcomes.
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Internal medicine journal · Mar 2023
ReviewHow toxic is an old friend? A review of the safety of hydroxychloroquine in clinical practice.
Hydroxychloroquine (HCQ) and its close relative chloroquine (CQ) were initially used as antimalarial agents but are now widely prescribed in rheumatology, dermatology and immunology for the management of autoimmune diseases. HCQ is considered to have a better long-term safety profile than CQ and is therefore more commonly used. ⋯ Debate around toxicity of HCQ in COVID-19 has challenged those who regularly prescribe HCQ to discuss its potential toxicities. Accordingly, we have reviewed the adverse effect profile of HCQ to provide guidance about this therapeutic agent in clinical practice.