Internal medicine journal
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Internal medicine journal · Feb 2025
Multicenter StudyPatients with functional gastrointestinal disorders spend less time in tertiary care when managed by a single clinician: results of a multicentre audit in South Australia.
Functional gastrointestinal disorders (FGIDs) impact quality of life and represent a significant burden on healthcare services. Guidelines recommend an early, positive diagnosis to reduce harmful over-investigation in FGID patients. The aim of this multicentre study was to evaluate FGID management against current guidelines. ⋯ Consistent delivery of clinical care reduces healthcare utilisation in the management of FGIDs. Further studies are needed to identify optimal care models for managing outpatients with FGIDs.
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Internal medicine journal · Feb 2025
Neoadjuvant chemotherapy in breast cancer: a retrospective pathway assessment in a regional cancer centre.
The optimal care pathway (OCP) for people with breast cancer provides a framework for investigation and management of patients with breast cancer, with delays previously identified regionally. ⋯ Adherence to OCP timeframes for patients undergoing neoadjuvant therapy in a regional centre was feasible and strategies are needed to bridge gaps identified for rural patients.
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Internal medicine journal · Feb 2025
Final results of the National Oncology Mentorship Program 2023 and its impact on burnout and professional fulfilment.
Significant burnout and low professional fulfilment are noted among medical oncologists and trainees. The National Oncology Mentorship Programme (NOMP23) was designed to evaluate the impact of a 1-year mentorship program between oncology trainees (mentees) and consultants (mentors) on improving professional fulfilment and burnout. ⋯ NOMP23 demonstrated that a centrally coordinated, low-cost mentorship program could be feasible and was of high value. Mentorship programs, alongside multifactorial institutional, state-based and national interventions to improve well-being, can help ensure a sustainable workforce.
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Internal medicine journal · Feb 2025
The impact of obstructive sleep apnoea on post-operative outcomes.
Unrecognised obstructive sleep apnoea (OSA) has been associated with adverse cardiorespiratory perioperative outcomes. However, with changing anaesthetic and perioperative management, there is ongoing uncertainty about the importance of OSA as a risk factor for post-operative complications. ⋯ Unrecognised OSA was not associated with an increase in clinically evident cardiorespiratory complications in this cohort. The lower complication rates compared with earlier studies suggest that increased use of less invasive surgical techniques, improved pain management and increased awareness of OSA have had an impact in reducing postoperative complications in this group. Further research is needed to clarify the impact of severe OSA on post-operative outcomes in different surgical cohorts with varying risk profiles in order to develop optimal perioperative pathways.
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Internal medicine journal · Feb 2025
Clinical utility of 18F-fluorodopa positron emission tomography in the movement disorder clinic: an Australian experience.
Differentiating idiopathic Parkinson disease (iPD) from other causes of tremor and parkinsonism based on clinical grounds can be challenging, particularly early in the course of disease or in the case of atypical clinical presentations. 18F-fluorodopa (F-DOPA) is a positron emission tomography (PET) radioligand that can be used to demonstrate the presence and pattern of striatal presynaptic dopaminergic deficit and, thus, assist in the diagnosis of iPD and related disorders. ⋯ There was significant change in provisional clinical diagnosis and management in the short term following review of F-DOPA PET results indicating significant clinical utility of F-DOPA PET in the Australian movement disorder clinic setting.