Internal Medicine Journal最新文献

HIV: is it now a thing of the past? 艾滋病：它现在是过去的事情了吗？

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-10-01 DOI: 10.1111/imj.70200

Jeffrey John Post

{"title":"HIV: is it now a thing of the past?","authors":"Jeffrey John Post","doi":"10.1111/imj.70200","DOIUrl":"https://doi.org/10.1111/imj.70200","url":null,"abstract":"Effective antiviral therapy for human immunodeficiency virus (HIV) has substantially reduced HIV-associated morbidity and mortality for people living with HIV (PLWH). The use of antiviral therapies as prevention, most notably pre-exposure prophylaxis (PrEP) as well as treatment as prevention (TasP), has significantly reduced the number of new infections in those using these biomedical prevention approaches (PrEP) and their sexual partners (TasP). However, nearly one-quarter of new HIV infections globally occur in the Asia-Pacific region (approximately 300 000 per annum) with a substantial number of deaths annually. Despite therapeutic advances, the total number of PLWH has increased worldwide. Although antiviral therapy has substantially reduced HIV-specific morbidity and mortality and is associated with significantly increased longevity, PLWH experience higher rates of chronic comorbidities than the general population. It is important that preventative approaches such as immunisation against specific conditions, lifestyle modification, smoking cessation and cancer screening are optimised for PLWH. Physicians are likely to care for PLWH in almost all subspecialties including aged care. Recent data support the use of organ transplantation in PLWH including from donors who also have HIV infection. HIV is most certainly not 'a thing of the past'.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extending the reach of clinical trials in regional, rural and remote Australia: lessons from the establishment of a statewide palliative care teletrial cluster. 扩大澳大利亚地区、农村和偏远地区临床试验的范围：建立全州姑息治疗远程试验集群的经验教训。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-10-01 DOI: 10.1111/imj.70181

Claire Stokes, Taylan Gurgenci, Anthony Herbert, Georgie Huggett, Melanie Poxton, Phillip Good

{"title":"Extending the reach of clinical trials in regional, rural and remote Australia: lessons from the establishment of a statewide palliative care teletrial cluster.","authors":"Claire Stokes, Taylan Gurgenci, Anthony Herbert, Georgie Huggett, Melanie Poxton, Phillip Good","doi":"10.1111/imj.70181","DOIUrl":"https://doi.org/10.1111/imj.70181","url":null,"abstract":"Over a quarter of Australians reside in rural and remote areas, where access to clinical trials is limited. This disparity affects the generalisability of trial results and may contribute to poorer health outcomes for rural and remote patients. Teletrials - where regional, rural, or remote research sites are connected to primary research sites via telehealth - can overcome geographic barriers and improve access to clinical trials. In April 2024, Queensland launched a palliative care teletrial cluster recruiting to a clinical trial investigating medicinal cannabis for advanced cancer symptoms. This innovative model differs from other teletrial models in that it utilises existing health jurisdictions to create a statewide research cluster. This approach has the potential to expand clinical trial access throughout Australia. However, procedural delays in setting up satellite sites and high setup costs underscore the need to reform trial management processes and prompt discussion about optimal decentralised trial models to achieve universal access to clinical trials.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Midodrine in the management of heart failure with reduced ejection fraction: a systematic review. Midodrine治疗心力衰竭伴射血分数降低：一项系统综述。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-27 DOI: 10.1111/imj.70207

Nicholas Pavic, Shane Zhang, Emilie Zhou, Alexander Maloof, Stephen Bacchi, Joshua Kovoor, Dennis Lau, Ammar Zaka, Joanne Eng-Frost, Pramesh Kovoor

{"title":"Midodrine in the management of heart failure with reduced ejection fraction: a systematic review.","authors":"Nicholas Pavic, Shane Zhang, Emilie Zhou, Alexander Maloof, Stephen Bacchi, Joshua Kovoor, Dennis Lau, Ammar Zaka, Joanne Eng-Frost, Pramesh Kovoor","doi":"10.1111/imj.70207","DOIUrl":"https://doi.org/10.1111/imj.70207","url":null,"abstract":"Background: Guideline-directed medical therapy (GDMT) has significantly improved outcomes of patients with heart failure with reduced ejection fraction (HFrEF). However, the presence of hypotension often limits GDMT up-titration. Midodrine is a peripheral vasoconstrictor that may improve blood pressure in select patients with HFrEF and enable the optimisation of medical therapy.Aims: This systematic review aimed to evaluate the safety and efficacy of midodrine in the treatment of HFrEF.Method: A systematic review was registered (CRD42024594291) and conducted in accordance with PRISMA guidelines. A search was completed on 29 September 2024 among PubMed, Medline, EMBASE, Cochrane and SCOPUS databases. Primary outcome measures included tolerance of GDMT, left ventricular ejection fraction (LVEF) recovery, heart failure hospitalisations and all-cause mortality.Results: Five studies were included (12 063 HFrEF patients). A meta-analysis was precluded due to heterogeneity in study design, population and reported outcomes. Two studies suggested that midodrine was associated with an increase in the prevalence of patients prescribed GDMT and improvements in LVEF. Two studies concluded that midodrine use was associated with increased hospitalisations, intensive care visits and mortality. One study suggested midodrine use was safe in patients with cancer and heart failure.Conclusion: There is a lack of high-quality evidence to support the use of midodrine to facilitate GDMT up-titration in HFrEF. Supporting evidence of improving GDMT tolerance and LVEF stems from observational studies without comparator groups. Randomised trials are urgently needed to determine whether midodrine safely facilitates GDMT in HFrEF patients.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety, tolerability and efficacy of the use of tixagevimab/cilgavimab as pre-exposure COVID-19 prophylaxis in kidney and simultaneous pancreas kidney transplant recipients. 在肾脏和同期胰腺肾移植受者中使用替沙吉维单/西gavimab作为暴露前预防COVID-19的安全性、耐受性和有效性

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-27 DOI: 10.1111/imj.70179

Wai H Lim, Jiayue Wang, Helen Pilmore, Stella McGinn, Anoushka Krishnan, Armando Teixeira-Pinto, Anh Kieu, Owen Ng, Germaine Wong

引用次数: 0

Fulminant pancreatogenic diabetes following upper abdominal irradiation. 上腹部照射后的暴发性胰源性糖尿病。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-27 DOI: 10.1111/imj.70205

Krisha Solanki, Angie Xiang, Anthony W Russell

引用次数: 0

Hepatitis B in transplant recipients: an Australian single-centre study of screening, vaccination and management. 乙肝移植受者：澳大利亚筛选、接种和管理的单中心研究。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-27 DOI: 10.1111/imj.70202

Joanne Peel, Mei Jie Tang, Catherine Orla Morrissey

{"title":"Hepatitis B in transplant recipients: an Australian single-centre study of screening, vaccination and management.","authors":"Joanne Peel, Mei Jie Tang, Catherine Orla Morrissey","doi":"10.1111/imj.70202","DOIUrl":"https://doi.org/10.1111/imj.70202","url":null,"abstract":"Background: There are limited existing data regarding the quality of hepatitis B (HepB) screening or management among transplant recipients who are at increased risk of donor-derived HepB infection.Aims: This study examined: (i) the rate of appropriate HepB screening prior to transplant, (ii) the rate of completion of the HepB course for those who required vaccination and (iii) the management of transplant recipients at risk of HepB-related adverse outcomes in our cohort, including the rate of HepB flare or reactivation.Methods: We performed a retrospective analysis of 400 transplant recipients (200 solid organ and 200 haemopoietic stem cell transplant recipients) from January 2020 to December 2021 at Alfred Health, Melbourne, Australia. Key information about HepB screening and vaccination was extracted from medical records. Progress notes were examined to assess the management of any HepB-related adverse events.Results: The pre-transplant HepB screening rate was 99.25%. Among those with vaccination records, 59.8% completed a HepB vaccination course. We observed variation in the duration of nucleoside analogue use as chemoprophylaxis among individuals with resolved HepB, ranging from 3 months to lifelong. HepB reactivation occurred in one recipient with prior resolved HepB during the study. The prevalence of chronic HepB was 0.75%, with all cases appropriately managed.Conclusion: Vaccination rates exceeded some international reports but fell short of recommendations. Lack of centralised vaccination records likely adversely impacted vaccination rates. Mechanisms to streamline HepB screening, vaccination and management peri-transplant should be explored to improve outcomes for this vulnerable cohort.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A, B, C or D? Goals of care: a need for a national structural framework. A， B， C还是D？护理目标：需要一个国家结构框架。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-27 DOI: 10.1111/imj.70217

Claire Michel, Ranjana Srivastava, Ashwin Subramaniam

引用次数: 0

Optimising penicillin allergy assessment in resource-limited settings: a Nepean perspective. 优化青霉素过敏评估在资源有限的设置：一个欧洲的观点。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70219

Sheng-Lun Jason Yan, Helena Jang, Pei Dai

引用次数: 0

Structured curriculum vitae scoring: a possible means to improve female representation in specialty selection? 结构化简历评分：提高女性在专业选择中的代表性的可能手段？

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70213

Brittany Suann, Christina Gao, Thomas Muecke, Haelynn Gim, Joshua Kovoor, Carol Bacchi, Weng Onn Chan, Sireesha Koneru, Pramesh Kovoor, Georgina V Long, Josephine Thomas, Sarah Zaman, R L Jeffree, Stephen Bacchi

引用次数: 0

Reversible withdrawal-induced bradykinesia-rigidity in alcoholic Parkinsonism. 酒精性帕金森病中可逆性戒断诱导的运动迟缓-强直。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70218

Yuchen She, Junyi Wang, Ying Liu, Lijuan Mo, Changhong Tan, Xi Liu, Lifen Chen

引用次数: 0