Internal medicine journal
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Internal medicine journal · Sep 2022
ReviewDiagnosis and management of primary central nervous system lymphoma: a Consensus Practice Statement from the Australasian Lymphoma Alliance.
Primary central nervous system lymphoma is a clinicopathological disease entity that accounts for 1% of all non-Hodgkin lymphoma (NHL). Advanced patient age, adverse disease biology and complexities of diagnosis and treatment render outcomes markedly inferior to systemic NHL. Despite this, an increasing evidence base, including limited randomised controlled clinical trial data, is informing optimal therapeutic strategies with methotrexate-based induction chemotherapy schedules and intensified consolidation in selected patients. This practice statement represents an evidence-based review of the literature and has been devised to assist healthcare professionals in the diagnosis and management of this disease.
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Internal medicine journal · Sep 2022
ReviewCannabis, cannabidiol and tetrahydrocannabinol in sport: An overview.
The World Anti-Doping Agency now allows cannabidiol (CBD) to be taken in elite sport, but has retained all other cannabinoids on its banned list. This, together with liberalisation of cannabis laws, has led to an increasing interest in its use in sport. ⋯ CBD possesses anti-inflammatory and analgesic properties that have not been adequately evaluated in the area of sport. Some formulations of CBD contain THC or other cannabinoids that may result in a positive drug test.
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Internal medicine journal · Sep 2022
Observational StudyThe prevalence, characteristics, and risk factors of frequently readmitted patients to an internal medicine service.
Unplanned hospital readmissions (HRA), which have been used as key performance index of healthcare quality, are becoming more prevalent. They are associated with substantial financial burden to hospital systems and considerable impacts on patients' physical and mental health. Patients with frequent readmissions are not well studied. ⋯ The risk factors associated with FRA were older age, indigenous status, being socially disadvantaged, having higher comorbidities and discharging against medical advice. Conditions that lead to FRA were mental disorders, alcohol/drug use and alcohol/drug-induced organic mental disorders and neoplastic disorders.
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Internal medicine journal · Sep 2022
A Virtual Clinic for Positive Faecal Occult Blood Tests enhances early access to bowel cancer screening and is well received by patients.
Colorectal cancer is the second most common cause of cancer-related mortality in Australia. As such, timely access to colonoscopy following a positive faecal occult blood test (FOBT) is an important aspect of the National Bowel Cancer Screening Program to reduce morbidity and mortality related to this condition. To reduce waiting times, a Sydney-based referral centre introduced a nurse-led virtual clinic (VC) in order to facilitate direct access colonoscopy for patients referred with a positive FOBT. ⋯ Nursing-led VC, with direct access colonoscopy for patients at increased risk of colorectal cancer, reduce waiting times to colonoscopy without an increase in adverse events and is well received by patients.
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Internal medicine journal · Sep 2022
COVID-19 Beliefs and Vaccination Uptake in Dialysis Patients: Lessons from an Anonymous Patient Survey.
There is a lack of data on how to best optimise uptake of COVID-19 vaccination in dialysis patients. ⋯ Vaccine hesitancy for COVID-19 in dialysis patients associates with less informed health beliefs, both about the disease and the risks of vaccination. Patients are more likely to get vaccinated if it is recommended by their nephrologist. Clinicians caring for dialysis patients have a key role in providing high-quality education and advice, representing an urgent opportunity for improvement in vaccination uptake against COVID-19.