Internal Medicine Journal最新文献

{"title":"Real-world outcomes after endovascular thrombectomy in patients with large infarct cores.","authors":"Daniel James Wellington, Joseph Donnelly, Jae Beom Hong, William K Diprose, P Alan Barber","doi":"10.1111/imj.16608","DOIUrl":"https://doi.org/10.1111/imj.16608","url":null,"abstract":"<p><p>Patients with large infarct cores on imaging at hospital presentation who are then treated with endovascular thrombectomy achieved functional independence rates ranging from 14%-30% in randomised controlled trials. We describe our 'real-world' experience with these patients. About one-third were independent at day 90, similar to trial results. This was associated with higher rates of complications and double the length of stay.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448899","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}

{"title":"Endoscopy volume and outcomes after the COVID-19 pandemic: results from a tertiary Australian centre","authors":"Matthew Peverelle,&nbsp;Ryan Hirsch,&nbsp;William Slifirski,&nbsp;Vinny Ea,&nbsp;Georgia Sun,&nbsp;Nikhita Sane,&nbsp;Andrew Nguyen,&nbsp;Dina Erceg,&nbsp;Andrew Wang,&nbsp;Samuel Tucker,&nbsp;Elaine Koh,&nbsp;Tony Long,&nbsp;Simon Hew","doi":"10.1111/imj.16642","DOIUrl":"https://doi.org/10.1111/imj.16642","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"337-338"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397127","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}

{"title":"Teaching contributions of senior clinicians in a Basic Physician Trainee training programme","authors":"Rhiannon L. Holdsworth,&nbsp;Harry Petropoulos,&nbsp;Michael C. Spies","doi":"10.1111/imj.16476","DOIUrl":"https://doi.org/10.1111/imj.16476","url":null,"abstract":"<p>Education of Basic Physician Trainees (BPTs) in preparation for their Royal Australasian College of Physician Divisional Examinations requires time contribution by senior medical staff towards formal teaching activities. This study, conducted at a major metropolitan teaching hospital, sought to quantify the time commitment of senior medical staff towards teaching of BPTs in one clinical year, as well as the perceptions of those staff regarding time commitments through anonymous questionnaire. Senior medical staff involved in formal teaching activities provided a mean of 10 h; questionnaire respondents indicated a mean contribution of 20 h. This study highlights the significant time contribution of senior medical staff to formal teaching activities for BPTs, as well as identifies possible unmeasured teaching contributions.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"297-299"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396789","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}

{"title":"Reducing hospitalisations of older adults towards the end of life","authors":"Isaac K. S. Ng,&nbsp;Desmond B. Teo,&nbsp;Li Feng Tan","doi":"10.1111/imj.16643","DOIUrl":"https://doi.org/10.1111/imj.16643","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"339"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397054","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}

{"title":"Cladophialophora bantiana central nervous system infection in an immunocompetent male","authors":"Victoria Jordan,&nbsp;Syeda Naqvi","doi":"10.1111/imj.16646","DOIUrl":"https://doi.org/10.1111/imj.16646","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"335-336"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396784","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}

{"title":"Identification and management of Wellens syndrome in an asymptomatic patient","authors":"Phillip Key,&nbsp;Kenney Abraham,&nbsp;Ryan Heslin","doi":"10.1111/imj.16645","DOIUrl":"https://doi.org/10.1111/imj.16645","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"333-334"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396795","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}

{"title":"Mitigating the ‘copy-pasting epidemic’ in the electronic medical records","authors":"Isaac K. S. Ng","doi":"10.1111/imj.16644","DOIUrl":"https://doi.org/10.1111/imj.16644","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"340-341"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397055","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}

{"title":"Post-colonoscopy colorectal cancer in the Western Australian population: analysis of patient, histopathological and molecular characteristics.","authors":"Claire L Harma, Thisuri Jayawardena, Ali G M Ismail, Vidit Lall, Priyanthi Kumarasinghe, Bastiaan De Boer, Christine Hemmings, Benhur Amanuel, Erin Kelty, Bob Mirzai, Belinda B Guo, Richard Allcock, Muna Salama, Spiro Raftopoulos, Ian Yusoff, Dev Segarajasingam, Wendy N Erber, Hooi Ee","doi":"10.1111/imj.16650","DOIUrl":"https://doi.org/10.1111/imj.16650","url":null,"abstract":"<p><strong>Background: </strong>Post-colonoscopy colorectal cancer (PCCRC), defined as colorectal cancer (CRC) detected after a cancer-negative colonoscopy, represents a key quality indicator for CRC detection and prevention. While most PCCRC is attributed to missed lesions, few studies examine pathologic and molecular characteristics of PCCRC to assess for possible de novo cancer formation causing PCCRC.</p><p><strong>Aim: </strong>The aim of this study was to identify cases of PCCRC where prior colonoscopy was adequate (A-PCCRC) versus inadequate (I-PCCRC) and compare both subtypes with spontaneous CRC (sCRC) in terms of patient factors, histopathology and molecular characteristics.</p><p><strong>Methods: </strong>This was a 12-year retrospective population-based study using a data set from the Western Australian Cancer Registry between 2000 and 2011. A-PCCRCs were identified by excluding lesions likely missed due to procedural factors or incomplete prior resection at index colonoscopy performed within 3-36 months of cancer diagnosis. Histopathological review and next-generation sequencing were conducted on subsets of patients with A-PCCRC and sCRC. Statistical analysis included univariable and multivariable regression models and chi-squared and Wilcoxon rank sum tests.</p><p><strong>Results: </strong>A total of 524 (3.81%) cases of PCCRC were identified out of 13 757 cases of CRC; 272 were A-PCCRC (1.98%) and 252 I-PCCRC (1.83%). Female sex, older age and proximal location were associated with A-PCCRC. Mutations in the PIK3CA gene were less common in A-PCCRC compared to sCRC.</p><p><strong>Conclusion: </strong>A significant percentage of PCCRC occurred despite adequate prior colonoscopy. Missed sessile serrated lesions may contribute to many of these cases; however, further studies are required to examine possible de novo cancer as a cause of PCCRC that may involve unique biological pathways.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390934","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}

{"title":"'Charge what you think you're worth': a qualitative study exploring the gender pay gap in medicine and the role of price transparency.","authors":"Camille La Brooy, Hana Sabanovic, Susan J Méndez, Jongsay Yong, Anthony Scott, Adam G Elshaug, Khic-Houy Prang","doi":"10.1111/imj.16649","DOIUrl":"https://doi.org/10.1111/imj.16649","url":null,"abstract":"<p><strong>Background: </strong>The gender pay gap in medicine is entrenched and has a negative impact on economic growth, institutional reputation and financial success, recruitment, retention and job satisfaction of female specialists and patient care. It also discourages women from entering specialist fields of medicine. In the Australian unregulated market setting, female specialists are not simply getting paid less, they are choosing to set lower fees than their male counterparts.</p><p><strong>Aims: </strong>We examine how implicit and explicit gender biases affect how fees are set and the potential role of price transparency in addressing the gender pay gap.</p><p><strong>Methods: </strong>We conducted 27 semi-structured interviews with medical specialists recruited via social media and medical society newsletters between June 2021 and March 2022. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis. Twenty surgeons and seven anaesthetists, 15 of whom identified as male and 12 as female, participated in this study. The primary outcomes and measures focused on the perspectives of surgeons and anaesthetists regarding fee-setting practices.</p><p><strong>Results: </strong>A combination of contextual and market- and gender-related factors was the source of the biases that determine fee setting. Further, information asymmetry in medicine in Australia underlies current fee-setting practices, exacerbating and entrenching false perceptions about women's skills as surgeons and anaesthetists. Women tend to internalise these biases, self-regulating their behaviours and how they set their fees.</p><p><strong>Conclusion: </strong>The gender pay gap is pervasive. Greater transparency on fees and quality could be explored as a potential solution to reduce pay inequality.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373948","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}

{"title":"Is Australia ready for the rollout of amyloid-targeting therapies for Alzheimer's disease? Results from a national survey characterising current infrastructure capability, workforce and training needs of memory and cognition clinics.","authors":"Johannes C Michaelian, Christopher C Rowe, Susan E Kurrle, Constance Dimity Pond, Michael Woodward, Sharon L Naismith","doi":"10.1111/imj.16637","DOIUrl":"https://doi.org/10.1111/imj.16637","url":null,"abstract":"<p><strong>Background: </strong>New amyloid-targeting monoclonal antibody (mAb) therapies for Alzheimer's disease (AD) are currently under review by the Therapeutic Goods Administration for use in Australia.</p><p><strong>Aims: </strong>To determine the infrastructure, workforce and training needs of Australian memory and cognition clinics in order to characterise health system preparedness for these therapies.</p><p><strong>Methods: </strong>A national, cross-sectional online survey of medical specialists.</p><p><strong>Results: </strong>Thirty medical specialists (geriatricians, n = 23; psychiatrists, n = 4; neurologists, n = 3) from 30 different clinics participated (public, 76.7%; private, 23.3%), including from metropolitan (73.3%), regional (20.0%) and rural (6.7%) areas. On average, clinics reported assessing 5.4 (SD = 3.2) new patients per week, of which 2.4 (range: 0-5) were considered to have mild cognitive impairment (MCI). Only 40% of clinics use biomarkers to assess whether patients with MCI have AD, and 45% have intravenous infusion capability. While the majority of clinicians were confident in their knowledge of mAbs, only 33% felt confident in using these. Identified impediments to clinical implementation included (i) lack of real-world experience, (ii) lack of current Models of Care and appropriate use guidelines, (iii) current clinic set-up and (iv) information about safety.</p><p><strong>Conclusions: </strong>Australia's health system preparedness for amyloid-targeting mAb therapies will require further investment in infrastructure, equity of access, clinician training and support. Long wait times already impact access to clinics, and with the forecast rise in MCI and dementia cases, services will need to be expanded, and appropriate Models of Care and clear and efficient inter-sector health pathways will be needed to prepare for the use of mAbs.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255547","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}