Internal medicine journal
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Internal medicine journal · Mar 2020
Who is afraid of biosimilars? Openness to biosimilars in an Australian cohort of patients with rheumatoid arthritis.
Biosimilars are increasingly adopted to improve affordability of biologics. An effective introduction of biosimilars requires an understanding of patient acceptance of these agents. ⋯ Patient concerns about biosimilar uptake mainly focus on concerns about its efficacy. There is a significant correlation between patient attitudes towards biosimilar and generic medicines.
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Internal medicine journal · Mar 2020
Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence-practice gap?
In Australia, one-third of human immunodeficiency virus (HIV) diagnoses occur late, with an estimated 11% of people with HIV unaware of their diagnosis. Undiagnosed and untreated HIV infection increases morbidity in the HIV positive person and allows onward transmission of HIV. ⋯ Although HIV testing rates for IC doubled following the intervention, they remained unacceptably low. The recently introduced electronic medical record presents opportunities to prompt HIV testing.
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Internal medicine journal · Mar 2020
Cancer-associated prothrombotic pathways: leucocytosis, but not thrombocytosis, correlates with venous thromboembolism in women with ovarian cancer.
Risk factors for venous thromboembolism in cancer vary between tumours. Leucocytosis, thrombocytosis, tumour histology and vascular compression may drive thrombosis in ovarian cancer. ⋯ Thrombocytosis >350 × 109 /L was frequent (63.8%), but not predictive of thrombosis. Identification of prothrombotic biomarkers may help personalise preventive treatments.
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Internal medicine journal · Mar 2020
Impact of lunar phase on outcomes following ST-elevation myocardial infarction.
There is a long-held belief in the association between the full moon and extremes of human behaviour and adverse health consequences. Small-scale studies are conflicting; however, most suggest no clear association between lunar phase and occurrence of acute coronary syndromes. ⋯ This study showed no significant difference in the incidence or cardiovascular outcomes and survival in patients with STEMI undergoing primary or rescue percutaneous coronary intervention during the lunar phases.
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Internal medicine journal · Mar 2020
Addition of low dose acetazolamide as an adjunct in patients undergoing high dose methotrexate is safe and beneficial.
High-dose methotrexate (HDMTx) is utilised in central nervous system lymphoma and acute lymphoblastic leukaemia due to its ability to penetrate the blood-brain barrier. Despite its efficacy, nephrotoxicity is a potentially serious toxicity that could also exacerbate other methotrexate-related toxicities and compromise dose intensity. Acetazolamide (AZL) is a carbonic anhydrase inhibitor that causes an increase in bicarbonate excretion and consequently urine alkalinisation. Following occurrences of HDMTx-induced acute kidney injury (AKI) due to inadequate urine alkalinisation at our institution, routine AZL was administered to appropriate patients from 2010 onwards. ⋯ AZL appeared to diminish the incidence of HDMTx-induced toxicities, including reducing oedema-related weight gain. With mild, preventable hypokalaemia as the only noteworthy toxicity, AZL could be considered as an adjunct to HDMTx patient care.