Internal medicine journal
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Internal medicine journal · Oct 2015
Multicenter StudyIpilimumab-induced hypophysitis in melanoma patients: an Australian case series.
Ipilimumab (Yervoy; Bristol-Myers Squibb) is a novel fully humanised monoclonal antibody that blocks cytotoxic T-lymphocyte antigen 4, an immune checkpoint molecule, to augment anti-tumour T-cell responses. It is associated with significant immune-related side-effects including hypophysitis. ⋯ There is significant morbidity associated with development of IH. We suggest guidelines to assist with early recognition and therapeutic intervention.
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Internal medicine journal · Jun 2015
Multicenter Study Observational StudyCompassionate access anti-tumour necrosis factor-α therapy for ulcerative colitis in Australia: the benefits to patients.
The efficacy of infliximab has been demonstrated in patients with both acute severe and moderate-severe ulcerative colitis (UC). However, there is a need for 'real-life data' to ensure that conclusions from trial settings are applicable in usual care. We therefore examined the national experience of anti-tumour necrosis factor-α (TNF-α) therapy in UC. ⋯ These data show an excellent overall benefit for anti-TNF-α therapy in both ASUC and MRUC. In particular, only short-duration anti-TNF-α was required in ASUC. These real-life data thus support the clinical trial data and should lead to broader use of this therapy in UC.
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Internal medicine journal · Jan 2015
Multicenter StudyFactors relating to consent for organ donation: prospective data on potential organ donors.
Obtaining family consent to organ donation is a significant obstacle to improving further Australian deceased organ donation rates. Currently, neither the consent rates for donors eligible to donate after circulatory death, nor factors that influence decision to decline or consent to donation in general are known in Australia. ⋯ Despite a small sample size, these findings describe current consent and donation rates and associated factors and may assist in improving conversations about organ donation.
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Internal medicine journal · Dec 2014
Randomized Controlled Trial Multicenter StudyMetoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study.
Limited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups. ⋯ Metoclopramide appears to be a promising candidate for the treatment of patients with intractable hiccups, with mild adverse events. However, further clinical trials are required to confirm these results.
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Internal medicine journal · Oct 2014
Multicenter StudyPrevalence and predictors of advance directives in Australia.
Advance care planning is regarded as integral to better patient outcomes, yet little is known about the prevalence of advance directives (AD) in Australia. ⋯ Despite efforts to improve uptake of advance care planning (including AD), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning, but steps are needed to ensure that planning, which occurs outside the health system, is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by state could also suggest that redesign of regulatory frameworks (such as a user-friendly and well-publicised form backed by statute) may help improve uptake of AD.