Internal Medicine Journal最新文献

{"title":"Clinical utility of ¹⁸F-fluorodopa positron emission tomography in the movement disorder clinic: an Australian experience.","authors":"Dennis Yeow, Matthew Fielder, Shane Hynard, Robert Adam, Matthew Katz, Alexander Lehn, Paul Thomas, John D O'Sullivan","doi":"10.1111/imj.16615","DOIUrl":"https://doi.org/10.1111/imj.16615","url":null,"abstract":"<p><strong>Background: </strong>Differentiating idiopathic Parkinson disease (iPD) from other causes of tremor and parkinsonism based on clinical grounds can be challenging, particularly early in the course of disease or in the case of atypical clinical presentations. ¹⁸F-fluorodopa (F-DOPA) is a positron emission tomography (PET) radioligand that can be used to demonstrate the presence and pattern of striatal presynaptic dopaminergic deficit and, thus, assist in the diagnosis of iPD and related disorders.</p><p><strong>Aims: </strong>To determine the clinical utility of F-DOPA PET in an Australian movement disorder clinic setting.</p><p><strong>Methods: </strong>Retrospective cohort study of movement disorder clinic patients referred for F-DOPA PET by four movement disorder neurologists over a 10-year period to a single Australian nuclear medicine centre. Results of F-DOPA PET scans were correlated with changes in provisional diagnosis and management in the short term following review of F-DOPA PET results.</p><p><strong>Results: </strong>A total of 105 F-DOPA PET scan results and patient records were examined. In this cohort, provisional clinical diagnosis was altered in 37.9% of patients, and changes to clinical management were made in 48.4% of patients in the short term following review of F-DOPA PET results. Changes in both diagnosis and management were more common following a normal F-DOPA PET scan result (42.4% and 53.0% respectively) than a scan consistent with iPD (23.5% and 32.4% respectively).</p><p><strong>Conclusions: </strong>There was significant change in provisional clinical diagnosis and management in the short term following review of F-DOPA PET results indicating significant clinical utility of F-DOPA PET in the Australian movement disorder clinic setting.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931774","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":"Clinical practice in an age of medical misinformation and conspiracy theories.","authors":"Li Xuan Choo, Isaac K S Ng, Li Feng Tan, Desmond B Teo","doi":"10.1111/imj.16588","DOIUrl":"https://doi.org/10.1111/imj.16588","url":null,"abstract":"<p><p>Medical misinformation (false health or medical-related information) has seen a rapid increase in volume recently, with the global surge in social media usage and further exacerbation by the COVID-19 pandemic. This may put more lives at stake, as misinformation is an often-cited reason that people make dangerous health choices, engage in harmful practices and reject beneficial health treatments. In this article, we explore the drivers and consequences, as well as suggest several strategies at the personal, educational and systemic level, for physicians to guide and communicate with patients who subscribe to medical misinformation.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931773","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":"Appropriateness of lumbar spine imaging in patients presenting to the emergency department with low back pain in a Western Australian tertiary hospital.","authors":"Aaron W K Mau, Helen I Keen, Catherine L Hill, Rachelle Buchbinder","doi":"10.1111/imj.16626","DOIUrl":"https://doi.org/10.1111/imj.16626","url":null,"abstract":"<p><strong>Background: </strong>The Australian Rheumatology Association identified the use of imaging in patients with low back pain without indication of serious pathology as a low-value practice.</p><p><strong>Aims: </strong>To determine the appropriateness of diagnostic lumbar spine imaging requests in patients with low back pain presenting to a Western Australian hospital's emergency department.</p><p><strong>Methods: </strong>We conducted a retrospective review of all adult patients (18 years and older) who presented with low back pain to the Fiona Stanley Hospital emergency department from 1 July 2020 to 31 December 2020. The appropriateness of the imaging requests was judged using the American College of Radiology's Appropriateness Criteria. The number and proportion of appropriate and inappropriate lumbar spine imaging requests were reported overall and by imaging modality together with reasons for the judgements.</p><p><strong>Results: </strong>A total of 1459 patients were included. Three hundred eight patients (21.1%) received lumbar spine imaging requests, with 350 diagnostic imaging requests eligible for analysis. Two hundred eighty (80.0%) imaging requests were judged to be appropriate (194/253 (76.7%) plain radiographs, 57/66 (86.4%) computed tomography, 29/31 (93.5%) magnetic resonance imaging). The most common reasons for an appropriate imaging request were suspected vertebral fracture (n = 223, 79.6%), followed by malignancy (n = 26, 9.3%). Of the 70 inappropriate imaging requests, 62 (88.6%) requests occurred in the absence of alerting features and eight (11.4%) requests were the wrong choice of modality.</p><p><strong>Conclusions: </strong>Four in five lumbar spine imaging requests for investigating low back pain were appropriate. Of the inappropriate requests, the most common reason was the absence of alerting features, while a small number were the incorrect imaging modality.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927005","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":"Healthcare burden of public hospital gout admissions in New South Wales, Australia.","authors":"Wing Wai Tse, Ben J Smith, Joanne Han, Nicholas Manolios, Peter Wong, Ken Cai","doi":"10.1111/imj.16604","DOIUrl":"https://doi.org/10.1111/imj.16604","url":null,"abstract":"<p><strong>Background and aims: </strong>In New Zealand, the Māori and Pacific Islander population has a higher rate of hospital admissions for gout; however, we lack data for these population groups who reside in Australia. This study examined the pattern of hospital gout admissions in New South Wales (NSW), the most populous state of Australia, with a particular focus on the Māori and Pacific Islander population.</p><p><strong>Methods: </strong>This was a retrospective cohort study exploring the pattern of gout admissions in NSW public hospitals in the financial years 2017/2018 to 2019/2020. All patients aged ≥20 years, admitted to hospital with gout as the principal diagnosis between 1 July 2017 and 30 June 2020, were included in this study. Outcomes measured included the number and costs of these hospital admissions. Crude and age-standardised admission rates were calculated.</p><p><strong>Results: </strong>Western Sydney Local Health District (LHD) and South Western Sydney LHD had the highest number of hospital admissions with a principal diagnosis of gout (n = 537 and 788 admissions, respectively) in the 3-year study period. Māori and Pacific Islanders had higher rates of admissions due to gout (109.9 admissions per 100 000 people, compared to 20.0 for non-Māori/non-Pacific Islanders) and were of younger age.</p><p><strong>Conclusions: </strong>This study highlights the ethnic and geographical disparities in gout hospital admissions in NSW, with the Māori and Pacific Islander population of Western and South Western Sydney disproportionately affected. Culturally appropriate gout management strategies may be needed in the Māori and Pacific Islander population to address the large number of gout cases in western and southwestern Sydney.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909573","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":"Prevalence and associations of cerebral microbleeds in an Australian memory clinic cohort.","authors":"Scott Wrigley, Ross Cody, Sanka Amadoru, Andrew Huynh, Olivia Galante, Christine Mandrawa, Nawaf Yassi, Paul Yates","doi":"10.1111/imj.16614","DOIUrl":"https://doi.org/10.1111/imj.16614","url":null,"abstract":"<p><strong>Background: </strong>Cerebral microbleeds (CMBs) are small brain haemorrhages, identified by magnetic resonance imaging (MRI). They indicate potential for cognitive decline and mortality in memory clinic attendees. The presence of more than four CMBs is exclusionary for some clinical trials of disease-modifying therapies for Alzheimer's disease (AD). The prevalence and clinical relevance of CMBs in Australian memory clinic populations has not been reported.</p><p><strong>Aims: </strong>To highlight the prevalence of CMBs in an Australian memory clinic cohort and explore associations with diagnoses, topography and cognitive performance.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 393 patients who attended a memory clinic (CDAMS) in Melbourne, Australia from January 2014 to December 2016 who underwent brain MRI. Data collected included age, gender, clinical diagnosis and cognitive scores. Univariable and multivariable regression analyses were performed to identify associations of CMBs with clinical and cognitive findings.</p><p><strong>Results: </strong>The prevalence of CMBs was 27% (n=107) with good inter-rater reliability (κ=0.75). CMBs were significantly associated with increasing age. Prevalence of CMBs was higher in people with mild cognitive impairment (MCI) (32%) and dementia (39%) compared with other diagnostic groups (p<0.001). Lobar-predominant CMB distribution was associated with AD diagnosis. Presence of multiple CMBs was associated with poorer cognitive performance overall.</p><p><strong>Conclusions: </strong>CMBs are common in an Australian memory clinic population and are associated with poorer cognitive performance. \"Real world\" prevalence of CMBs may limit accessibility to disease-modifying therapies for many people.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907088","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":"Can artificial intelligence improve patient educational material readability? A systematic review and narrative synthesis.","authors":"Mohamed Nasra, Rimsha Jaffri, Davor Pavlin-Premrl, Hong Kuan Kok, Ali Khabaza, Christen Barras, Lee-Anne Slater, Anousha Yazdabadi, Justin Moore, Jeremy Russell, Paul Smith, Ronil V Chandra, Mark Brooks, Ashu Jhamb, Winston Chong, Julian Maingard, Hamed Asadi","doi":"10.1111/imj.16607","DOIUrl":"https://doi.org/10.1111/imj.16607","url":null,"abstract":"<p><p>Enhancing patient comprehension of their health is crucial in improving health outcomes. The integration of artificial intelligence (AI) in distilling medical information into a conversational, legible format can potentially enhance health literacy. This review aims to examine the accuracy, reliability, comprehensiveness and readability of medical patient education materials (PEMs) simplified by AI models. A systematic review was conducted searching for articles assessing outcomes of use of AI in simplifying PEMs. Inclusion criteria are as follows: publication between January 2019 and June 2023, various modalities of AI, English language, AI use in PEMs and including physicians and/or patients. An inductive thematic approach was utilised to code for unifying topics which were qualitatively analysed. Twenty studies were included, and seven themes were identified (reproducibility, accessibility and ease of use, emotional support and user satisfaction, readability, data security, accuracy and reliability and comprehensiveness). AI effectively simplified PEMs, with reproducibility rates up to 90.7% in specific domains. User satisfaction exceeded 85% in AI-generated materials. AI models showed promising readability improvements, with ChatGPT achieving 100% post-simplification readability scores. AI's performance in accuracy and reliability was mixed, with occasional lack of comprehensiveness and inaccuracies, particularly when addressing complex medical topics. AI models accurately simplified basic tasks but lacked soft skills and personalisation. These limitations can be addressed with higher-calibre models combined with prompt engineering. In conclusion, the literature reveals a scope for AI to enhance patient health literacy through medical PEMs. Further refinement is needed to improve AI's accuracy and reliability, especially when simplifying complex medical information.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884824","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":"Sodium-glucose cotransporter 2 inhibitors reduce albuminuria in patients with Fabry disease: a real-world case series.","authors":"Anthea Tsatsaronis, Mark Tiong, Kathleen Nicholls, Irene Ruderman","doi":"10.1111/imj.16603","DOIUrl":"https://doi.org/10.1111/imj.16603","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease is a rare X-linked multisystem disease, with progressive proteinuric kidney disease contributing significantly to morbidity and mortality of these patients. Evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2Is) can reduce proteinuria and slow progression to end-stage kidney disease in both diabetic and non-diabetic kidney disease.</p><p><strong>Aim: </strong>Evaluate the effects of SGLT2I on kidney function and albuminuria in patients with Fabry disease.</p><p><strong>Methods: </strong>Single-centre real-world case series reviewing electronic medical records of patients with Fabry disease who initiated therapy with dapagliflozin or empagliflozin (n = 11). Changes in urine albumin-creatinine ratio (uACR) and creatinine before and after treatment with SGLT2I were analysed using Wilcoxon signed-rank test. Two-tailed P-values <0.05 were considered significant.</p><p><strong>Results: </strong>Eleven patients were followed for up to 19 months after commencement of SGLT2I. An overall significant reduction in albuminuria (P = 0.05) was seen with SGLT2I use in the Fabry cohort. Median uACR before SGLT2I was 76 mg/mmol (interquartile range (IQR) 47-141) and after SGLT2I was 39 mg/mmol (IQR 18-95) (P = 0.05). All patients with uACR >100 mg/mmol had reduction in albuminuria over the study period. SGLT2Is were well tolerated overall, with only one case resulting in cessation of treatment due to adverse effects.</p><p><strong>Conclusion: </strong>These results suggest SGLT2Is can significantly reduce albuminuria in a portion of patients with Fabry-related kidney disease and offer additional treatment for Fabry nephropathy. Given the nature of the study design and small case numbers, further long-term controlled studies are required to evaluate the long-term efficacy of this medication class in both cardiac and renal outcomes in Fabry disease.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885001","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":"Characteristics and management of eosinophilic esophagitis in Australasian children: a decade of experience.","authors":"Hamish Philpott, Daniel A Lemberg, Andrew S Day, Jeremy Rosenbaum, Harveen Singh, Sarah Rumore, Samuel Ellison, Michael Couper, Jody Porter, Amin Roberts, Kunal Thacker, David Moore, Glenn Furata, Ajay Sharma","doi":"10.1111/imj.16558","DOIUrl":"https://doi.org/10.1111/imj.16558","url":null,"abstract":"<p><strong>Background: </strong>The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children.</p><p><strong>Aim: </strong>To determine the incidence, prevalence, clinical characteristics and management of eosinophilic esophagitis (EoE) in Australasian children.</p><p><strong>Methods: </strong>Retrospective audit of endoscopic records, histology reports and case notes (ICD code) over a 10-year period (1 January 2008 to 31 December 2018). Cases were defined as having >15 eosinophils per high-power field (HPF) at endoscopy and oesophageal biopsy, while treatment response was defined as <5 eosinophils per HPF. Included were patients aged 0-18 years presenting to tertiary paediatric hospitals in seven capital cities (Adelaide, Auckland, Brisbane, Christchurch, Melbourne, Perth and Sydney), while those with conditions that could cause eosinophilia (organ transplantation, hyper-eosinophilic syndrome) or taking medications that may influence tissue eosinophilia (systemic corticosteroids immunosuppressants) were excluded. Australian Bureau of Statistics and Stats NZ were used to define comparative population data. Demographics (age at diagnosis, gender, country of birth, race) comorbidities (atopic conditions, e.g. asthma, seasonal rhinitis, eczema) and treatment (diet, steroids, proton pump inhibitors) were noted.</p><p><strong>Results: </strong>The prevalence of EoE ranged from 15 to 54 per 100 000 children, where cases were more common in Adelaide than other localities. Incidence increased significantly in all sites across the 10 years, with peak incidence in Adelaide of 6.4 per 100 000 children in 2017. EoE was most frequent in males (male:female ratio = 3:1) and >90% were white Caucasian. Polynesian racial background in Auckland (10%) and middle eastern racial background in Sydney (10%) were the next most frequent. Treatment choice varied across sites, and greater than 30% of patients did not undergo endoscopy to assess initial treatment success.</p><p><strong>Conclusion: </strong>The prevalence of EoE in Australasian children is comparable to that observed elsewhere, and the incidence is increasing significantly. Regional differences in disease frequency, management practices and access to endoscopy warrant further study.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881875","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":"Excipient induced allergies in oral medications: unravelling the covert threat - a systematic review.","authors":"Shrey Seth, Lipin Lukose, Kamal Sud, Jing Xin Goh, Wubshet Tesfaye, Fatima Small, Sathvik B Sridhar, Ronald L Castelino","doi":"10.1111/imj.16605","DOIUrl":"https://doi.org/10.1111/imj.16605","url":null,"abstract":"<p><p>Excipients have been identified as 'inert' substances that often enhance the non-pharmacological aspects of a medication. However, recent clinical evidence elucidates their potential in inducing anaphylaxis and indicates that they are often overlooked as potential allergens in routine clinical practice. The aim of the study was to assimilate published evidence on excipient-induced allergies associated with the use of oral medications and to underline their potential as potent allergens. A systematic literature search of MEDLINE, EMBASE and International Pharmaceutical Abstracts databases was performed for case reports published from inception to June 2024. Studies were excluded if they were animal and laboratory studies or not published in English, full-text articles were unavailable, and they lacked essential information. This systematic review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Polyethylene glycol was the most prevalent allergenic excipient, followed by colouring agents. Clinical manifestations exhibited wide variability ranging from mild to life-threatening reactions, and the most common presentations were urticaria and angioedema. Most patients recovered spontaneously after withdrawal of the offending agent with less than half necessitating additional drug interventions and only a single instance of reported fatality, which cannot be attributed to the excipient alone. Despite being labelled as inert, excipients pose a significant threat for the development of allergic reactions. Simple measures such as increased awareness among patients and healthcare professionals, comprehensive history taking, reviewing medication compositions and improved patient awareness regarding potentially allergenic excipients can aid in avoiding these readily preventable reactions.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881886","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 yield of upper gastrointestinal tract endoscopy and colonoscopy in patients with iron deficiency anaemia while on direct oral anticoagulants.","authors":"Victor Ching, Karen Hay, Ivan Hui, Ann Vandeleur, Prisca Har, Tony Rahman, Alaa Alghamry","doi":"10.1111/imj.16616","DOIUrl":"https://doi.org/10.1111/imj.16616","url":null,"abstract":"<p><strong>Background: </strong>Iron deficiency anaemia (IDA) related to occult gastrointestinal tract (GIT) blood loss is associated with high rates of GIT malignancies. Major society guidelines recommend bidirectional endoscopic evaluation for all men and post-menopausal women with newly diagnosed, unexplained IDA. However, in patients prescribed direct oral anticoagulants (DOACs), the endoscopic yield, specifically the rate of high-risk findings, including colorectal cancers (CRCs) and advanced adenomas (AAs), is unknown.</p><p><strong>Aim: </strong>Our aim is to determine the endoscopic yield, specifically the prevalence of these high-risk findings in patients presenting with new-onset unexplained IDA while on a DOAC.</p><p><strong>Methods: </strong>This is a single-centre, retrospective analysis performed at a tertiary hospital in Australia. Between January 2015 and July 2019, 178 consecutive patients underwent endoscopic evaluation for IDA while prescribed a DOAC. Patient demographics, laboratory data, medications and endoscopic findings were summarised and compared by diagnostic yield. Associations were explored using logistic regression analysis.</p><p><strong>Results: </strong>CRCs were present in 2/178 (1.1% (95% confidence interval (CI): 0.1-4.0)) patients. AAs were found in 35/178 (19.6% (95% CI: 14.1-26.3)) patients. The most common AAs were tubular adenomas (45.7%), tubulovillous (31.4%) and sessile serrated adenomas (14.2%). Older age (P = 0.013) and lower ferritin levels (P = 0.009) were associated with the presence of high-risk findings.</p><p><strong>Conclusion: </strong>In patients presenting with new-onset, unexplained IDA while on a DOAC, the prevalence of CRCs is lower than previously reported in studies involving populations not prescribed DOACs. Conversely, there is a higher incidence of AAs, including high-risk histological features, such as tubulovillous adenomas and sessile serrated polyps.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881883","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}