Internal medicine journal
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Internal medicine journal · Dec 2022
ReviewGuidance for transfusion management in patients receiving magrolimab therapy (anti-CD47 monoclonal antibody).
Magrolimab (Hu5F9-G4) is a first-in-class anti-CD47 IgG4 monoclonal antibody, with potential applications in several malignancies including myelodysplastic syndrome. CD47 blockade in malignancy has been shown to promote antitumour effects. However, the ubiquity of CD47 on red blood cells can result in interference in pretransfusion immunohaematology investigations and hinder timely provision of red blood cell units, with potential to mask clinically significant alloantibodies. ⋯ Antibody screening using an antihuman globulin reagent that does not detect human IgG4 subclass may distinguish magrolimab interference from an underlying alloantibody in patient plasma. Clear and consistent protocols for laboratories and close communication with clinicians are paramount to facilitate timely and safe transfusion support for patients receiving magrolimab therapy. As local transfusion laboratories gain experience with magrolimab, this will assist in our understanding and comfort in managing these patients.
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Internal medicine journal · Dec 2022
Telemedicine to Timor-Leste: implementing an international cardiac telehealth service during population dislocation, floods and COVID-19.
The East Timor Hearts Fund has provided cardiac services in Timor-Leste since 2010, conducting three clinics yearly. ⋯ Our pilot telehealth clinics indicate that capacity-building telemedicine can be rapidly implemented in an emergency setting internationally. Clinic design benefits from careful identification and resolution of challenges to optimise flow. Cardiac patients in Timor-Leste have a significant burden of disease amenable to intervention.
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Internal medicine journal · Dec 2022
Outcomes following parathyroidectomy for secondary hyperparathyroidism in patients with chronic kidney disease - a single-centre study.
Surgical parathyroidectomy may be required for severe and refractory secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD). Parathyroidectomy is associated with long-term survival benefit despite an increase in short-term morbidity and mortality. Global variation in practice exists, with limited Australian data on outcomes following parathyroidectomy. ⋯ Significant fluctuations in serum calcium levels are common post-parathyroidectomy; however, long-term morbidity and mortality in our cohort were lower than previously reported, highlighting that parathyroidectomy in a carefully selected cohort is safe for severe SHPT refractory to medical treatment.
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Internal medicine journal · Dec 2022
'So near and yet so far': the early women of the Royal Australasian College of Physicians - the first 20 female MRACP 1938-1947.
At the time of the inauguration of the Royal Australasian College of Physicians in 1938, there were 232 Foundation Fellows, but only five were women. Those who wished to gain a postgraduate qualification for internal medicine or related specialties then sat for Membership of the new College. In the first decade (1938-1947), 250 gained Membership, but only 20 were women. ⋯ Still, they all showed great determination and contributed significantly to their chosen fields, while many combined a busy practice with family life. They improved the path for those women who followed. Their stories, however, are rarely reported.