Internal medicine journal
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Internal medicine journal · Jan 2025
Comparative StudyComparison of cardiovascular risk prediction in type 1 diabetes: an Australian viewpoint.
Cardiovascular disease (CVD) is a significant burden in individuals with type 1 diabetes mellitus (T1DM). Yet the optimal method of CVD risk stratification remains uncertain. We found that the new Australian CVD risk calculator could overestimate risk category compared with the Steno Type 1 Risk Engine and underestimate risk category compared with the new Swedish/Scottish prediction tool, both of which were validated for T1DM. More research is needed to derive a CVD risk assessment pathway for individuals with T1DM in Australia.
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Internal medicine journal · Jan 2025
Clinical practice in an age of medical misinformation and conspiracy theories.
Medical misinformation (false health or medical-related information) has seen a rapid increase in volume recently, with the global surge in social media usage and further exacerbation by the COVID-19 pandemic. This may put more lives at stake, as misinformation is an often-cited reason that people make dangerous health choices, engage in harmful practices and reject beneficial health treatments. In this article, we explore the drivers and consequences, as well as suggest several strategies at the personal, educational and systemic level, for physicians to guide and communicate with patients who subscribe to medical misinformation.
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Internal medicine journal · Jan 2025
Real-world impact of pembrolizumab availability for deficient mismatch repair metastatic colorectal cancer.
Immunotherapy has emerged as a standard treatment for deficient mismatch repair (dMMR) metastatic colorectal cancer (mCRC). Pembrolizumab became widely available as a first-line (1L) option in Australia following the Pharmaceutical Benefits Scheme (PBS) listing in August 2021. The uptake of new treatment options can be lengthy. ⋯ Previously reported associations of dMMR were observed. The higher-than-expected proportion of patients with dMMR is likely driven by the inclusion of older patients in this real-world study. Many patients were able to access immunotherapy prior to PBS listing, potentially through trials or access programs. Early uptake of pembrolizumab following PBS listing has been high, and this effective and well-tolerated option has increased the proportion of elderly patients receiving active therapy.
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Internal medicine journal · Jan 2025
ReviewDiagnosis and management of mantle cell lymphoma: a consensus practice statement from the Australasian Lymphoma Alliance.
Mantle cell lymphoma (MCL) is a clinically heterogeneous B-cell neoplasm with unique clinicopathological features, accounting for 5% of all non-Hodgkin lymphoma. Although for many chemoimmunotherapy can lead to durable remissions, those with poor baseline prognostic factors, namely blastoid morphology, TP53 aberrancy and Ki67 >30%, will have less durable responses to conventional therapies. With this in mind, clinical trials have focused on novel targeted therapies to improve outcomes. This review details the recent advances in the understanding of MCL biology and outlines the recommended diagnostic strategies and evidence-based approaches to treatment.