Internal medicine journal
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Internal medicine journal · Sep 2024
Letter Case ReportsInsulin amyloidosis: an under-recognised entity.
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Internal medicine journal · Sep 2024
ReviewGender-affirming hormone therapy for transgender and gender-diverse adults in Australia.
Gender-affirming hormone therapy (GAHT) is used by many transgender and gender-diverse adults to align physical characteristics with their gender identity, reduce gender incongruence and improve psychological functioning. This narrative review provides an overview of the initiation and monitoring of GAHT in an Australian context. Trans individuals treated with testosterone typically receive standard testosterone doses and formulations recommended for cisgender men, whereas those receiving estradiol GAHT are typically treated with estradiol in combination with an anti-androgen in those without orchidectomy. Proactive monitoring and mitigation of cardiovascular risk factors is pertinent in all transgender and gender-diverse adults and bone health is an important consideration in those using estradiol GAHT.
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Internal medicine journal · Sep 2024
Phenotypes of inflammatory bowel disease in the Māori population of New Zealand.
Māori have historically seen a lower rate of inflammatory bowel disease (IBD) compared to New Zealand's non-Māori population. Recent reports have shown an increasing rate of IBD among Māori patients. ⋯ We present the largest study describing IBD in Māori. IBD phenotypes in Māori were similar to previous regional IBD reports, but there was a significantly higher proportion of female patients with CD in Māori and an earlier second age peak at 45-49 years. Increasing incidence of IBD in Māori has again been demonstrated.
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Internal medicine journal · Sep 2024
Do video or telephone consultations impact attendance rates in an addiction medicine specialist outpatient clinic?
Effective alcohol and other drugs (AODs) treatment has been proven to increase productivity and reduce costs to the community. Telehealth has previously been proven effective at delivering AOD treatment in the right settings. Yet, Australia's current Medicare funding restricts telephone consultations. ⋯ While physical attendance may be required for specific clinical care, telephone consultations are associated with increased attendance and can form an important adjunct to delivering addiction treatment. Given the substantial costs of substance use disorders, this could inform government policies and funding priorities to further improve access and treatment outcomes.
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Internal medicine journal · Sep 2024
General physicians' perspectives on SGLT2 inhibitors for heart failure.
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are novel agents for heart failure (HF) and are now recommended in guidelines. Understanding general physicians' perspectives can help to optimise utilisation of this new medication. ⋯ General physicians in Australia and Aotearoa New Zealand are familiar with the therapeutic knowledge and side effects of SGLT2is. Patient complexity, medication cost and discontinuity of care were significant barriers to the use of SGLT2is for HF among general physicians.