Internal medicine journal
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Internal medicine journal · Feb 2020
Multicenter StudyUtilisation of systemic therapy options in routine treatment of metastatic colorectal cancer in Australia.
In the treatment of metastatic colorectal cancer (mCRC), exposure to all three active cytotoxic agents, 5-fluorouracil/capecitabine, irinotecan and oxaliplatin, improves overall survival. The addition of biologic agents (bevacizumab and cetuximab/panitumumab) further improves survival. The uptake of available systemic agents for mCRC in routine practice in Australia is poorly described. ⋯ In this community-based cohort, 33% of patients had not received any systemic therapy for mCRC, and few patients had received all available active systemic agents. As many patients remain alive, these figures will likely increase over time. The overall survival of patients with mCRC in this community-based cohort was 25 months and not dissimilar to that achieved in recent clinical trials.
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Internal medicine journal · Feb 2020
Observational StudyCentralised versus outreach models of cystic fibrosis care should be tailored to the needs of the individual patient.
Cystic fibrosis (CF) is a common life-limiting genetic condition. As the disease progresses access to specialist tertiary multi-disciplinary care services may become necessary. For patients living in regional/remote Australia, accessing such services may be a challenge. Here, we describe long-term outcomes for CF patients according to their access to specialist CF centre care in childhood.
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Lead poisoning is an uncommon and challenging diagnosis to make. In 2018, The Victorian Department of Health issued a health warning following four cases of lead poisoning associated with illicit opium use in Melbourne, Australia. ⋯ All cases occurred in recent immigrants to Australia, who had access to non-traditional sources of opioids. Health care professionals should consider lead poisoning in patients with appropriate symptoms and a history of illicit opium use.
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Internal medicine journal · Feb 2020
Clinical factors leading to a change in management in chronic hepatitis B patients managed in a tertiary setting.
Newer antiviral agents for chronic hepatitis B (CHB) are highly effective, with minimal risks of complications and development of resistance. ⋯ The majority of stable CHB patients on highly potent antiviral treatment do not require alteration of management. While additional investigations are required, this study highlights the potential for a shared primary care approach in highly selected CHB patients.
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Internal medicine journal · Feb 2020
Being an internist throughout the world - same name, different training curricula.
In the 79 countries revised, two fundamental internal medicine (IM) training patterns were in evidence, first, only basic training needed, requiring a 3-4-year residency period for obtaining the diploma of internist; and advanced training needed, requiring 5-7 years of study. Second, evaluation of common IM training for sub-specialists revealed the following three patterns: dual training; core training and separate training.