Internal Medicine Journal最新文献

{"title":"Respiratory mortality in prisons during the 1918-1919 influenza pandemic.","authors":"G Dennis Shanks","doi":"10.1111/imj.70637","DOIUrl":"https://doi.org/10.1111/imj.70637","url":null,"abstract":"<p><p>Prisons are among the most controlled human environments, and prisoners often suffer epidemic disease when influenza is introduced into these restricted populations. A review of contemporary records of five prison systems during the 1918-1919 influenza pandemic showed that most prison populations did remarkably well under lockdown, with few resulting respiratory deaths. Exceptional prisons with high respiratory mortality included the Andaman Islands prison colony (17.3/1000) and the US Army Disciplinary Barracks (42/1000) at Fort Leavenworth, Kansas. Factors that likely resulted in high respiratory mortality included the absence of earlier waves of influenza-like illness and increased prisoner turnover introducing additional respiratory bacteria strains. Prison staff often had influenza rates that were very different to those of the prisoners they were guarding. Although free populations resented social restrictions during the COVID-19 pandemic, controlling population movements can serve to limit respiratory pathogen spread while waiting for alternative public health measures such as immunisations to arrive.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220234","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":"Assessing the quality of end-of-life care in systemic sclerosis.","authors":"Julie McDonald, Lisa Kiven, Sophia To, Navera Ahmed, Laura Ross","doi":"10.1111/imj.70652","DOIUrl":"https://doi.org/10.1111/imj.70652","url":null,"abstract":"<p><strong>Background: </strong>Systemic sclerosis (SSc) is a rare autoimmune disease with the highest mortality among rheumatic diseases, yet little is known about the quality of end-of-life care in SSc.</p><p><strong>Aims: </strong>To evaluate end-of-life care in SSc against the Australian National Consensus Statement's Essential Elements for high-quality end-of-life care and compare care between palliative care unit (PCU) and non-PCU deaths.</p><p><strong>Methods: </strong>This retrospective single-centre study included adults with SSc who died between 2013 and 2023 at a tertiary SSc referral centre. Terminal admission records for expected deaths were mapped to the National Consensus domains. Fisher exact and Mann-Whitney U tests compared PCU and non-PCU deaths.</p><p><strong>Results: </strong>Thirty-three patients died. Six unexpected deaths were excluded, leaving 15 PCU and 12 non-PCU deaths. Multidisciplinary involvement was extensive, particularly from rheumatology and allied health. Palliative care engagement was common, goals of care were frequently reviewed and communication about dying with next-of-kin occurred in most cases. Patients dying outside the PCU had lower rates of documented recognition of dying, significantly greater intensive care involvement and more frequent medical emergency team calls. They also received more potentially non-beneficial investigations and treatments during the final 48 h of life and incurred substantially higher terminal admission costs.</p><p><strong>Conclusion: </strong>End-of-life care in SSc was broadly consistent with the National Consensus standards, identifying strong rheumatology involvement, multidisciplinary care and frequent palliative care referral. However, differences in care according to site of death highlight opportunities to increase proactive palliative care involvement and regular review of goals of care to ensure high-quality end-of-life care across all settings.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166754","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":"Methodological considerations in interpreting outcomes after biologic dose escalation in inflammatory bowel disease.","authors":"Umema Mangi, Muhammad Hassan","doi":"10.1111/imj.70658","DOIUrl":"https://doi.org/10.1111/imj.70658","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136003","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":"Performance and concordance of contemporary large language models on Royal Australasian College of Physicians examination questions: an exploratory analysis.","authors":"Rohan Joshua Krishnaswamy, Joseph Julian Suttie","doi":"10.1111/imj.70664","DOIUrl":"https://doi.org/10.1111/imj.70664","url":null,"abstract":"<p><p>We assessed six publicly available large language models (LLM) on Royal Australasian College of Physicians (RACP) adult medicine written examination questions. In a 30-question set with answers, models achieved 93% correct responses overall, and accuracy was higher for text-based than visual-media questions. In a 170-question exploratory set without an answer key, complete inter-model agreement occurred in 86% of questions but was lower for visual-media than text-based questions and for scenario-based than knowledge-based questions. Contemporary LLM performed strongly on RACP-style written questions, but interpretation of visual media and complex clinical vignettes remains a limitation.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136248","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":"Australia: where developing and developed worlds collide - a unique opportunity to understand environmental triggers of inflammatory bowel disease.","authors":"Gurtej Singh, Jonathan P Segal","doi":"10.1111/imj.70651","DOIUrl":"https://doi.org/10.1111/imj.70651","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135976","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":"Diagnostic uncertainty in presumed stricturing Crohn disease: peritoneal tuberculosis presenting with caecal perforation.","authors":"Faris Gondal, Joshua Haron Abasszade, Megan Burns, Elizabeth Lockie, Michael Flood, Jacob McCormick, Lachlan Philip, James McCarthy, Neeha Rajan, Neeraj Bhala, Finlay Macrae","doi":"10.1111/imj.70659","DOIUrl":"https://doi.org/10.1111/imj.70659","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127442","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":"COVID-19-associated intractable mucormycosis successfully treated with nivolumab and interferon-gamma.","authors":"Chaithanya Jeganathan, Peter Mbewe, Eric Chu, Andrew McLean-Tooke","doi":"10.1111/imj.70657","DOIUrl":"https://doi.org/10.1111/imj.70657","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109294","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":"Taking responsibility for the environmental impact of medical societies.","authors":"Sadia Jahan, Jane Waugh","doi":"10.1111/imj.70653","DOIUrl":"https://doi.org/10.1111/imj.70653","url":null,"abstract":"<p><p>It is well recognised that modern healthcare has an enormous carbon footprint that is contributing to the climate crisis. However, the contribution of medical societies and their associated activities is largely ignored. The Australian and New Zealand Society of Nephrology and its Environmental Sustainability Committee (ESC) are taking action to mitigate their impact on climate change. This viewpoint describes actions taken since the formation of the ESC in 2017 and serves as encouragement for all medical societies to incorporate environmental sustainability into their everyday practice.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109282","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":"Diabetic striatopathy due to severe hyperglycaemia in regional Victoria, Australia.","authors":"Thomas Sutherland, Ian Haryono, Fariha Islam","doi":"10.1111/imj.70654","DOIUrl":"https://doi.org/10.1111/imj.70654","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109233","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":"Epidemiology and health burden of infective endocarditis: a comparative analysis of Australian vs global trends from 1990 to 2021.","authors":"David M Chye, Kate L Drummond, Thalys Sampaio Rodrigues, Elizabeth Paratz, Robert Horvath, Eugene Athan, Louise M Burrell, Natasha E Holmes, Olivia C Smibert, Anoop N Koshy","doi":"10.1111/imj.70612","DOIUrl":"https://doi.org/10.1111/imj.70612","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is an uncommon but life-threatening disease with evolving patient risk profiles and management strategies. However, its impact on the Australian healthcare system has not been described.</p><p><strong>Aims: </strong>To quantify the healthcare burden of IE in Australia over time in the past three decades and compare outcomes with global and high-income settings.</p><p><strong>Methods: </strong>Data extracted from Global Burden of Disease 2021 included IE prevalence, mortality, disability-adjusted life years (DALY), and heart failure (HF) attributed to IE from 1990 to 2021. Each metric was further indexed to age-adjusted prevalence and expressed as summary rates per 100 IE cases (e.g. prevalence-adjusted mortality rate), and were stratified by geographical groups (Australia, Global and High-Income), sex and 5-year age groups.</p><p><strong>Results: </strong>Between 1990 and 2021, 8 563 131 IE cases were reported worldwide, with 0.74% occurring in Australia. In Australia, age-adjusted prevalence rates of IE (AAPR) quadrupled over time (AAPR_AUS: 2.63-10.18 per 100 000 persons), whilst prevalence-adjusted mortality rates (PAMR) and disability rates (PADR) declined (PAMR_AUS: 18.6-11.25 deaths per hundred cases; PADR_AUS: 440-244 DALY per hundred cases). Australia reported a growth in prevalence-adjusted heart failure rates (PAHR_AUS: 68.4-86.8 HF per hundred IE cases). Across all geographical groups, including Australia, bimodal peaks in mortality and disability affected middle-aged (40-64 years) and elderly populations (≥75 years). IE prevalence was relatively even between sexes; males experienced higher IE mortality and disability, while females experienced a greater burden of heart failure.</p><p><strong>Conclusions: </strong>Australia's IE profile is distinct, with a sharper rise in prevalence and IE-associated heart failure, despite declining mortality and disability. These findings suggest improved survival but increasing chronic morbidity, underscoring the need for enhanced post-acute care models and further research to explore underlying drivers, including evolving risk factors, healthcare access and long-term cardiac outcomes.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109236","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}