Internal Medicine Journal最新文献

{"title":"Rapid desensitisation therapy in a patient with furosemide-induced anaphylactic shock: a case report and short-term follow-up","authors":"Chuanwei Zhao, Yane Yang, Shizhen Gao","doi":"10.1111/imj.70041","DOIUrl":"10.1111/imj.70041","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"688-689"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752411","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":"Audit of linkage to care and administration of immunoprophylaxis to infants born to mothers with chronic hepatitis B infection at Monash Health 2014–2022","authors":"Cian Lenihan,&nbsp;Anna B. Pierce,&nbsp;Edura Jalil,&nbsp;Rhonda L. Stuart","doi":"10.1111/imj.70048","DOIUrl":"10.1111/imj.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevention of mother-to-child transmission of hepatitis B virus (HBV) is essential to achieve the World Health Organization's goal of eliminating HBV as a public health threat by 2030. This study examines the management of HBV in pregnant women and newborns at a large tertiary health service in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the timely administration of hepatitis B immune globulin (HBIG) and the birth dose vaccine to infants born to mothers with chronic hepatitis B (CHB) and to assess maternal referral to specialist care, viral load (VL) testing and antiviral therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study reviewed medical records of women with CHB who delivered at Monash Health from 2014 to 2022. Data were extracted on maternal referral to specialist care, VL testing, antiviral use and administration timing of HBIG (within 12 h) and hepatitis B vaccine (within 24 h) to newborns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 895 infants, 99.7% received both HBIG and the birth dose vaccine; 97.4% received the vaccine within 12 h, and 88.3% received HBIG within the recommended 12-h window. Maternal referral rates to specialist care were 83.1%, with 91.06% undergoing VL testing during pregnancy. Antiviral therapy was administered to 16% of women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High uptake of HBV immunoprophylaxis was observed, with most infants receiving timely vaccination and HBIG. However, variability exists in maternal referral and antiviral treatment. Continued efforts are needed to improve comprehensive care and reduce transmission risk across diverse settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"932-936"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac medication non-adherence: the elephant in the room","authors":"Kristoffer K. Ralota,&nbsp;Misha Dagan,&nbsp;John Lee,&nbsp;Vardhaman Gowda,&nbsp;Jamie Layland","doi":"10.1111/imj.70042","DOIUrl":"10.1111/imj.70042","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"690-691"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752294","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":"Concern about the ‘Gender-Affirming’ treatment approach","authors":"Mike McDonough","doi":"10.1111/imj.70043","DOIUrl":"10.1111/imj.70043","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"692-693"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752326","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":"Glucocorticoid-induced diabetes screening in patients with autoimmune diseases attending hospital outpatient clinics","authors":"Zhi X. Leang,&nbsp;Joy Lim,&nbsp;P. Gerry Fegan,&nbsp;Brittany Stevenson","doi":"10.1111/imj.70044","DOIUrl":"10.1111/imj.70044","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"684-686"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752265","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":"Short course antiviral therapy to prevent donor-derived hepatitis C virus infection","authors":"Peter Boan,&nbsp;Kate Proudmore,&nbsp;Ashley Irish,&nbsp;Jagadish Jamboti,&nbsp;Lynette A. Pereira,&nbsp;J. Owen Robinson","doi":"10.1111/imj.70038","DOIUrl":"10.1111/imj.70038","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"687"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752414","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":"Author reply to McDonough","authors":"Brendan J. Nolan,&nbsp;Ada S. Cheung","doi":"10.1111/imj.70040","DOIUrl":"10.1111/imj.70040","url":null,"abstract":"&lt;p&gt;We appreciate McDonough's&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; letter but note that it contains frequently debunked disinformation.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Our Clinical Perspective article ‘Gender affirming hormone therapy for transgender and gender-diverse adults in Australia’ provides recommendations for the initiation and monitoring of gender-affirming hormone therapy (GAHT) in transgender and gender-diverse (trans) adults.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Despite this, McDonough raises concerns about trans children and youth,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; which is beyond our article's scope. Furthermore, our article is unrelated to the Cass review of gender identity services for children in the United Kingdom, a flawed and unbalanced report inconsistent with established global standards.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Gender-affirming care is an evidence-informed, patient-centred approach that supports trans individuals in their personal goals of better aligning their physical, psychological and social characteristics with their gender identity.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; It has the goals of improving mental health, reducing gender dysphoria and enhancing overall quality of life, while respecting individual values and bodily autonomy. In contrast to simply ‘accepting the subjective interpretation of gender by a young person’, gender-affirming care involves comprehensive evaluation of coexisting mental health conditions and facilitating self-exploration of identity and gender, as well as social and psychological support.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Some but not all trans individuals request GAHT and/or surgical interventions. Notably, these interventions are associated with improvements in mental health, including reductions in gender dysphoria, depression and suicidality in trans adults&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt; and youth.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;McDonough's claim that the World Professional Association for Transgender Health (WPATH) is ‘discredited’ relies on a non-peer-reviewed source from a conservative Christian lobby group. Gender-affirming care is supported by not only WPATH but also over 30 professional medical associations, including the Australian Medical Association and the Royal Australasian College of Physicians.&lt;span&gt;&lt;sup&gt;9-11&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Similarly, the notion of social contagion or rapid-onset gender dysphoria is unsubstantiated. The only study suggesting it, based on parental reports rather than direct engagement with trans youth, has been widely criticised and corrected.&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; Population data contradict this theory, showing stabilisation of the number of people identifying as trans&lt;span&gt;&lt;sup&gt;13&lt;/sup&gt;&lt;/span&gt; and stable proportions of gender dysphoria diagnoses over time.&lt;span&gt;&lt;sup&gt;14&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Restricting gender-affirming care or waiting to find the ‘cause’, as proposed by McDonough, is unethical and harmful and completely disregards the lived experiences and needs of trans individuals, who are not a ‘new dis","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 4","pages":"694-695"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practice and attitudes in emergency department management of primary spontaneous pneumothorax in Australia and New Zealand: a scenario-based/survey","authors":"Anne-Maree Kelly,&nbsp;Sanjeevan Muruganandan,&nbsp;Peter Jones,&nbsp;Gerben Keijzers,&nbsp;Fran Kinnear,&nbsp;Peter Cameron,&nbsp;Arash Badiei,&nbsp;YC Gary Lee,&nbsp;Julian A Smith,&nbsp;Emma Ball,&nbsp;Ethan Bacon,&nbsp;Roland Bammer,&nbsp;Diana Egerton-Warburton","doi":"10.1111/imj.70054","DOIUrl":"10.1111/imj.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Management of primary spontaneous pneumothorax (PSP) has long been contentious.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To identify the factors influencing interventional versus conservative management and to assess current practice patterns for moderate-to-large PSP in emergency department (ED) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anonymous online survey of emergency medicine, respiratory medicine and thoracic surgery specialists and trainees in Australia and New Zealand. Data collected included rating the decision-making importance of potential drivers of interventional versus conservative management for PSP, initial management preference for stable patients with moderate-large PSP based on three X-ray-based scenarios (one moderate-large, one almost total collapse without mediastinal shift and one large with mediastinal shift) and awareness of evidence and current guidelines for the management of PSP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 456 responses; 85.5% were from Australia. The most commonly reported factors influencing treatment decision-making were vital signs (96.7%) and patient-reported dyspnoea (84.3%). There was variation between specialty groups in initial treatment preference for all scenarios (<i>P</i> &lt; 0.001) and a reduction in preference for conservative treatment as the magnitude of radiological features increased (93.8% vs 61.5% vs 32.1% respectively). Guideline recommendation awareness was low except for the 2023 British Thoracic Society guideline (60.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates variation of opinion regarding the initial management of stable patients with moderate to large PSP and an increasing preference for intervention as the magnitude of radiological features increases. Guideline awareness was low, highlighting the need for an evidence-based approach to PSP management in the ED that is widely understood and accepted across speciality groups and that prioritises patient symptoms over X-ray findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"944-950"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges for implementing generative artificial intelligence (GenAI) into clinical healthcare.","authors":"Lynden J Roberts, Rajiv Jayasena, Sankalp Khanna, Leslie Arnott, Paul Lane, Chris Bain","doi":"10.1111/imj.70035","DOIUrl":"https://doi.org/10.1111/imj.70035","url":null,"abstract":"<p><p>Generative artificial intelligence (GenAI) is a form of deep learning AI based on inference that offers significant potential in healthcare. It has versatile capabilities: GenAI excels in complex human language communication, synthesising information from large and diverse datasets and performing broad, complex tasks reliably. Other important capabilities include scalability, 'always on' and cost effectiveness. Taken together, GenAI technology appears to possess considerable potential for healthcare. However, the implementation poses several challenges, including technological problems, regulatory considerations, workforce impact and building trust. Using evidence and expert opinion to explore these issues, the review aims to inform clinical experts about this rapidly evolving field.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709776","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":"Shorter-term and longer-term mortality prediction in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study","authors":"Dunya Tomic,&nbsp;Agus Salim,&nbsp;Elizabeth L. M. Barr,&nbsp;Paul Z. Zimmet,&nbsp;Dianna J. Magliano,&nbsp;Jonathan E. Shaw","doi":"10.1111/imj.70015","DOIUrl":"10.1111/imj.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While identification of key risk factors for mortality has contributed to advances in healthcare, the effect of these risk factors in predicting mortality over different time horizons remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We sought to determine how risk factors predicted shorter-term and longer-term mortality across the age spectrum in adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from 11 247 adults of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Cox multivariable regression models were used to estimate hazard ratios (HRs) of shorter-term (0–10 years) and longer-term (10–20 years) all-cause and cardiovascular disease (CVD)-related mortality associated with risk factors. Models with interaction between baseline age and each risk factor were also fitted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a 20-year follow-up, 2185 deaths occurred. Smoking, diabetes, male sex and albuminuria all independently predicted shorter- and longer-term all-cause and CVD mortality. Most associations were stronger in the shorter term compared to the longer term. A notable exception was the association between smoking and CVD mortality, which was stronger in the longer term (HR 3.55, 95% confidence interval (CI) 2.57–4.90) compared to the shorter term (HR 2.06, 95% CI 1.33–3.20). The magnitude of association between most risk factors and mortality attenuated with age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Classical risk factors for total and CVD mortality remain important up to 20 years after their measurement. In unselected adult cohorts, longer-term follow-up (e.g. beyond 10 years) may not provide additional information on associations of risk factors with mortality beyond that obtained in shorter-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"922-931"},"PeriodicalIF":1.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}