Internal medicine journal
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There continues to be significant interest from both clinicians and patients in using faecal transplantation, as the integral role of the gut microbiome is increasingly recognised in various disease conditions, both within and beyond the gut. This Clinical Perspectives article provides an overview of existing literature, factors limiting the use of faecal microbial transplantation in clinical practice and exciting new advancements on the horizon.
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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.
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Cytomegalovirus (CMV) infections continue to be associated with significant morbidity and mortality following solid organ transplantation and haemopoietic stem cell transplantation. Advances in understanding the biology of CMV in the immunosuppressed host will translate into improved management approaches and better clinical outcomes. Updated definitions of resistant and refractory CMV infections will lead to more consistent reporting of CMV outcomes, better inform appropriate antiviral strategies and influence clinical trial design. ⋯ As the boundaries of transplantation are extended, new patterns of CMV infection are being recognised. Finally, recent studies support the use of novel antiviral therapies in transplant recipients in the appropriate clinical setting. In this review, we provide an update on important new and emerging concepts in the management of CMV in immunosuppressed transplant recipients.
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Internal medicine journal · Jan 2025
ReviewPatient-driven personal importation in the face of cost barriers to care: can we do better?
Australia has a robust public health system that helps to make medicines affordable. However, evidence shows that a significant proportion of Australians still cannot afford medicines prescribed to them and that some patients import medicines from abroad as a result. ⋯ Although personal importation is the most obvious option, regulation leaves scope for other possibilities. We propose that guidance should be developed to help physicians address cost-related medicine non-adherence in practice and to help them understand their options and how to navigate them at the individual, speciality and professional levels.
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Internal medicine journal · Dec 2024
ReviewCharting the course: a scoping review on telehealth research trends in Australia.
This review of telehealth research describes the landscape of Australian digital health and telehealth research from 1999 to 2022, focusing on outlining past, present and future trends. A scoping review was conducted using the Joanna Briggs Institute methodology and PRISMA extension for scoping reviews framework, which identified 495 primary research studies of digital or telehealth interventions aimed at improving health outcomes. ⋯ Despite increasing interest in digital and telehealth interventions, the rural and remote populations that stand to benefit the greatest are under-represented in the literature. Future research should focus on these groups, using both emerging and established technologies, and digital and telehealth interventions should be adopted by a wider breadth of health professions.