Internal medicine journal
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Internal medicine journal · Feb 2020
Multicenter StudyUtilisation of systemic therapy options in routine treatment of metastatic colorectal cancer in Australia.
In the treatment of metastatic colorectal cancer (mCRC), exposure to all three active cytotoxic agents, 5-fluorouracil/capecitabine, irinotecan and oxaliplatin, improves overall survival. The addition of biologic agents (bevacizumab and cetuximab/panitumumab) further improves survival. The uptake of available systemic agents for mCRC in routine practice in Australia is poorly described. ⋯ In this community-based cohort, 33% of patients had not received any systemic therapy for mCRC, and few patients had received all available active systemic agents. As many patients remain alive, these figures will likely increase over time. The overall survival of patients with mCRC in this community-based cohort was 25 months and not dissimilar to that achieved in recent clinical trials.
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Internal medicine journal · Dec 2019
Multicenter StudyDischarge treatment with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker after a heart failure hospitalisation is associated with a better prognosis irrespective of left ventricular ejection fraction.
Medical therapy could improve the prognosis of real-life patients discharged after a heart failure (HF) hospitalisation. ⋯ Discharge treatment with ACE inhibitor/ARB after a HF hospitalisation is associated with a reduction in all-cause and refractory HF mortality, irrespective of LVEF.
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Internal medicine journal · Nov 2019
Multicenter Study Comparative StudyAssessment of agreement and time in therapeutic range of capillary versus venous international normalised ratio in frail elderly people in a nursing home.
Vitamin K antagonists are widely used, yet have a slim therapeutic margin and high iatrogenicity. Patients are monitored through international normalised ratio (INR) by venipuncture, but coagulometers could measure INR by capillary puncture. ⋯ Concordance was good and mean time in therapeutic range (TTR) markedly increased. Capillary INR is thus reliable, could improve TTR and decrease iatrogenicity.
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Internal medicine journal · Nov 2019
Multicenter StudyAssociation between ribociclib and changes in creatinine in patients with hormone receptor positive metastatic breast cancer.
Combination ribociclib and aromatase inhibitors are currently the preferred treatment in Australia for newly diagnosed hormone receptor positive metastatic breast cancer in the absence of visceral crisis. In our case series of 32 patients, 28% experienced grade 1 elevations in creatinine, a toxicity that was under-recognised in large phase III studies. Creatinine rise appears to be due to a reversible inhibition of renal efflux transporters rather than an acute kidney injury in the majority of cases.