Internal medicine journal
-
Internal medicine journal · Jun 2023
ReviewCerebral amyloid angiopathy: Clinical Presentations and Management Challenges in the Australian Context.
Cerebral amyloid angiopathy (CAA) is a disease with several clinical manifestations. It is characterised by amyloid-beta deposition in cerebral blood vessels, making them prone to bleeding. The incidence of CAA increases with age and may be associated or co-exist with intraparenchymal neurodegenerative proteinopathies, which makes it an increasingly relevant condition for adult physicians in all areas of medical practice. ⋯ CAA is asymptomatic in many older adults but increases the risk of fatal intracerebral or subarachnoid haemorrhage. We review the existing literature on CAA and summarise the key findings. We specifically explore clinical challenges relevant to CAA, particularly in diagnosis, management of intracranial haemorrhage and management of concurrent medical conditions.
-
Internal medicine journal · Jun 2023
Review Case ReportsCulture-negative Capnocytophaga canimorsus meningitis diagnosed by 16s ribosomal RNA polymerase chain reaction in an immunocompetent veterinarian and a review of the literature.
Capnocytophaga canimorsus is a fastidious, capnophilic and facultative anaerobic Gram-negative rod found commonly in the oral flora of dogs that may cause zoonotic infections such as cellulitis and eye infections. In immunocompromised patients, it may cause fulminant sepsis. Meningitis due to C. canimorsus is, however, a rare manifestation. This is the first reported case of C. canimorsus meningitis in Australia in an immunocompetent veterinarian diagnosed by 16s ribosomal RNA polymerase chain reaction.
-
Internal medicine journal · Jun 2023
Observational StudyActivity and Outcomes of Autologous Stem Cell Transplantation in the Private Sector in Australia.
Few Australasian autologous stem cell transplantation (ASCT) programmes perform ASCT in the private sector. Relatively little is known about ASCT outcomes in the private sector, which varies in care delivery models to the public system. ⋯ We report excellent OS and low TRM, demonstrating the critical role of the private sector in the administration of this highly complex therapy. The Icon ASCT programme is the largest ASCT contributor in Queensland. It is inclusive of patients aged ≥70 years, demonstrating low and acceptable TRM.
-
Internal medicine journal · Jun 2023
ReviewPlerixafor use in New Zealand 2016-2019: An Observational Study.
Plerixafor is used to mobilise CD34-positive stem cells for autologous transplantation to treat haematological malignancy. Funded in New Zealand since 2016, plerixafor can be used 'pre-emptively' to salvage a failing first attempt or as a 'rescue' strategy involving re-mobilising after 4 weeks. The rate of failed mobilisation and plerixafor uptake in New Zealand is not known, while international practice varies widely. ⋯ Plerixafor strategies in New Zealand allow successful stem cell mobilisation for ≥96% of patients. Further research is required to investigate whether increased use would be cost-effective through reduced chemotherapy and apheresis duration, and improved graft quality.
-
Internal medicine journal · Jun 2023
Observational StudyWorkforce challenges across Victorian Medical Oncology Services.
Cancer incidence is growing, with increasing treatment options and durations. This has led to an increase workload on the current oncology workforce. The global pandemic has increased this pressure further. ⋯ The medical oncology workforce in Victoria is inadequate to meet current and future demands. This needs to be addressed urgently to avoid an adverse impact on cancer measures and quality standards. Better, standardised data collection is needed to allow for ongoing measures of workforce activity. Novel workforce solutions will also need to be implemented in the short and medium term in the face of global workforce shortages.