Internal medicine journal
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Internal medicine journal · Feb 2011
Review Case ReportsRituximab-induced serum sickness in refractory immune thrombocytopenic purpura.
Serum sickness may occur in patients treated with chimeric monoclonal antibody. Rituximab, an anti-CD20 chimeric monoclonal antibody, is used with increasing frequency in chronic immune thrombocytopenic purpura (ITP). Rituximab is relatively safe; however, serum sickness is reported in 1-20% of patients, more commonly among those with autoimmune conditions. We describe a case of serum sickness in a patient with ITP and review the literature of rituximab-induced serum sickness.
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Internal medicine journal · Feb 2011
JAK2 mutations in Asian patients with essential thrombocythaemia.
JAK2V617F is an acquired mutation present in a considerable proportion of patients with chronic myeloproliferative disorders. Its reported prevalence in European and US studies of patients with essential thrombocythaemia (ET) is 23-57%. This study was conducted to determine the prevalence of the JAK2 mutation in Asian ET patients, and to examine their disease profile. ⋯ The prevalence of JAK2 mutations in this population of Asian ET patients was 34%. Patients with the JAK2 mutation were significantly more likely to have high-risk disease. Further studies are required to assess the role of JAK2 mutations in risk stratification in ET and compare the phenotype of Asian patients with other populations.
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Internal medicine journal · Feb 2011
Time and geographical variations in utilization of endocrine therapy for breast cancer in Australia.
Endocrine therapies, aromatase inhibitors and tamoxifen, are commonly used as an adjuvant treatment in women with breast cancer. ⋯ Use of aromatase inhibitors has overtaken use of tamoxifen in 2008. Further real-world effectiveness data are required to evaluate whether large associated increases in expenditures partly because of the higher costs of aromatase inhibitors are actually justified.
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Severe sepsis is defined as organ dysfunction in the setting of systemic inflammatory response due to infection. With changes in population age, comorbidity and the delivery of medical care, severe sepsis is increasingly common, and can present in every area of the hospital. ⋯ Against this, substantial reductions in mortality can be achieved by improving recognition, urgent care and resuscitation. With a view to improving survival in sepsis, collaborative efforts are required to measure outcomes, implement guidelines and secure adequate funding for ongoing practice improvement, education and research.