Internal medicine journal
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Internal medicine journal · Oct 2024
Identify, screen and treat via electronic pathway: a semiautomated approach to retriaging a liver clinic waitlist.
Long specialist outpatient waiting lists are a source of clinical risk. Triage assignment is based on subjective assessment of referrals and fails to account for dynamic changes in disease status while patients await clinical review. ⋯ This study successfully implemented a semiautomated strategy that prioritises patients with probable advanced liver disease or active HCV, demonstrating enhanced patient engagement with LCG support. It highlights the burden of patients referred for specialist care and the need for innovative strategies for monitoring and objective risk stratification.
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Internal medicine journal · Sep 2024
Colorectal polyps in young adults: a retrospective review of colonoscopy data from Toowoomba and the Darling Downs.
Polyps are the predominant precursors of colorectal cancer. In the past three decades, the incidence and mortality rates of colorectal cancer have been increasing in adults younger than 50 years. ⋯ Data from this audit supported the temporal trend of increasing prevalence of polyps in adults younger than 50 years. Patient cohorts aged 30-39 and 40-49 years may benefit from earlier first colonoscopies. Findings could be the impetus for future research in young adults presenting for colonoscopy.
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Internal medicine journal · Sep 2024
Therapeutic drug monitoring in anticancer agents: perspectives of Australian medical oncologists.
In the development of anticancer agents for solid tumours, body surface area continues to be used to personalise dosing despite minimal evidence for its use over other dosing strategies. With the development of tyrosine kinase inhibitors and other oral targeted anticancer agents, dosing using therapeutic drug monitoring (TDM) is now utilised in many health systems but has had limited uptake in Australia. ⋯ Despite the limited experience of TDM in oncology in Australia, medical oncologists appear positive about the potential benefit to their patients. We have identified three barriers to implementation that could be targeted for increased adoption of TDM in oncology in Australia.
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Internal medicine journal · Sep 2024
Australian rheumatologists' perception of autologous haemopoietic stem cell transplantation for the treatment of systemic sclerosis: a cross-sectional survey.
Autologous haemopoietic stem cell transplantation (AHSCT) is an effective treatment for systemic sclerosis (SSc); however, treatment-related toxicity remains a key issue. ⋯ In this national survey of rheumatologists, AHSCT is considered an accepted therapy. However, concern about toxicity remains a potential barrier to patient referral. Access, studies to refine patient selection and development of AHSCT protocols that improve safety were identified as key areas of need.