Internal Medicine Journal最新文献_第2页

A large long-term database of Gaucher disease patients demonstrates increased risk of lymphoma and myeloma, but not of solid tumours. 一个大型的戈谢病患者的长期数据库显示淋巴瘤和骨髓瘤的风险增加，但实体瘤的风险没有增加。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70221

Majdolen Istaiti, Tama Dinur, Ora Paltiel, Barbara Silverman, Shoshana Revel-Vilk, Ari Zimran

{"title":"A large long-term database of Gaucher disease patients demonstrates increased risk of lymphoma and myeloma, but not of solid tumours.","authors":"Majdolen Istaiti, Tama Dinur, Ora Paltiel, Barbara Silverman, Shoshana Revel-Vilk, Ari Zimran","doi":"10.1111/imj.70221","DOIUrl":"https://doi.org/10.1111/imj.70221","url":null,"abstract":"Background: Gaucher disease (GD) has been variably associated with cancer risk, with conflicting reports in the literature. Understanding the true cancer burden is critical for patient care and genetic counselling.Aim: To determine the overall and site-specific cancer risk in a large, single-centre GD cohort over three decades.Methods: This is a retrospective cohort study based at a national referral centre. Medical records of 709 GD patients aged >20 years at Shaare Zedek Medical Center were reviewed. Cancer diagnoses were confirmed using the Israel National Cancer Register. Cancer-free survival was estimated via Kaplan-Meier analysis. Standardised incidence ratios (SIRs) compared observed versus expected cancer cases.Results: Sixty-four (9%) patients were diagnosed with cancer. The most common malignancies were breast, non-Hodgkin lymphoma (NHL) and colon cancer. The overall incidence was 3.7 (95% confidence interval (CI): 2.6-4.8) per 1000 person-years. Cancer risk correlated with age but not gender, genotype, splenectomy status or GD therapy. The overall SIR was 0.9 (95% CI: 0.6-1.1), indicating no increased overall cancer risk. However, SIRs for haematological malignancies, including NHL and multiple myeloma, were elevated.Conclusions: GD patients do not have an increased general cancer risk, though vigilance for haematological malignancies is warranted. Previous literature might have overestimatee risk due to selection bias. These findings support tailored screening strategies and may alleviate patient concerns.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149024","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

Incidence of syphilitic hepatitis among patients with neurosyphilis. 神经梅毒患者中梅毒性肝炎的发病率。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70197

Jessica Sun, Louis Wang, Christopher Pokorny

引用次数: 0

A challenging case of serum vasoactive intestinal peptide-negative vasoactive intestinal peptide-secreting tumour as cause of severe chronic diarrhoea. 一例具有挑战性的血清血管活性肠肽阴性血管活性肠肽分泌肿瘤引起严重的慢性腹泻。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70220

Phillip Te, Sahan Withanage, Carl Cosgrave, Damian Dowling, Mohammed Al-Ansari

引用次数: 0

Impact of lack of immunisation against diphtheria in the Australian military during the Second World War. 第二次世界大战期间澳大利亚军队缺乏白喉免疫接种的影响。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70211

G Dennis Shanks

引用次数: 0

Continuous temperature monitoring for the detection of fever in haemato-oncology patients: a pilot study of two wearable devices (THERMAL). 用于检测血液肿瘤患者发热的连续体温监测：两种可穿戴设备（THERMAL）的试点研究。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-26 DOI: 10.1111/imj.70199

Robert Cameron Fyfe, Maria Larsen, Danielle Blud, Robert Weinkove

引用次数: 0

Demographic, imaging and disease patterns of moyamoya angiopathy in South Auckland: an observational study from electronic health records. 南奥克兰烟雾血管病的人口统计学、影像学和疾病模式：一项来自电子健康记录的观察性研究

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-24 DOI: 10.1111/imj.70209

Karim Mahawish, Ann Anson, Annemarei Ranta, Rita Krishnamurthi

{"title":"Demographic, imaging and disease patterns of moyamoya angiopathy in South Auckland: an observational study from electronic health records.","authors":"Karim Mahawish, Ann Anson, Annemarei Ranta, Rita Krishnamurthi","doi":"10.1111/imj.70209","DOIUrl":"https://doi.org/10.1111/imj.70209","url":null,"abstract":"Background: Prior reports show the occurrence of moyamoya angiopathy in the ethnically diverse South Auckland region, but little is known about the sociodemographic burden of the condition and clinical outcomes.Aims: To determine the disease prevalence, age, sex and ethnic distribution, management and patient outcomes in adults residing in South Auckland (population 567 000). We also sought to determine associations with the outcomes of vascular events and functional independence following diagnosis.Methods: We searched hospital medical records and radiology reports dating from 2008 to 2024 for the region using relevant ICD codes and the word 'moyamoya'. We used descriptive statistics and local population data to calculate point prevalence as of 19 September 2024. Statistical tests of association were performed for continuous, categorical and time-to-event data for the prespecified outcomes.Results: We identified 49 patients with a total of 300 patient-years of follow-up. The point prevalence ranged from 4/100 000 in NZ Europeans and Asian people to 10/100 000 in Māori and 14/100 000 in Pacific Islanders. The mean age at diagnosis was 37 (standard deviation 16) years and females outnumbered males by 3:1. One-quarter had a vascular event within a median of 457 days from diagnosis and two-thirds of the overall cohort were independent on follow-up. Factors associated with a loss of independence included stroke/transient ischaemic attack (TIA) during follow-up, bilateral disease and severe hypoperfusion on imaging. The mortality rate was 14%.Conclusions: In this New Zealand-based study, we found a wide ethnic variation in the prevalence of moyamoya angiopathy and an elevated early risk of TIA and stroke following diagnosis.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130735","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

Incidence of aspirin resistance in high-risk patients following elective total hip and knee arthroplasty. 选择性全髋关节置换术后高危患者阿司匹林抵抗的发生率。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-24 DOI: 10.1111/imj.70204

Nameer van Oosterom, Michael Barras, Robert Bird, Neil Cottrell

{"title":"Incidence of aspirin resistance in high-risk patients following elective total hip and knee arthroplasty.","authors":"Nameer van Oosterom, Michael Barras, Robert Bird, Neil Cottrell","doi":"10.1111/imj.70204","DOIUrl":"https://doi.org/10.1111/imj.70204","url":null,"abstract":"Aspirin resistance (AR) is linked to increased morbidity and mortality after cardiovascular and neurovascular procedures but has not been investigated after total hip arthroplasty (THA) and total knee arthroplasty (TKA). To investigate the incidence of AR in high-risk patients after elective THA/TKA, we conducted a prospective cohort study of elective THA/TKA in patients with thromboembolic risk factors: obesity (body mass index [BMI] ≥30 kg/m2), diabetes and/or advanced age (≥65 years) who were administered aspirin for venous thromboembolism prophylaxis. AR was confirmed using a platelet function analyser. Forty patients were included with a mean±standard deviation age of 66.1±10.4 years and BMI of 32.2±6.0 kg/m2 and eight (20.0%) had diabetes. Overall, 52.5% of patients were aspirin resistant, with no statistically significant relationships between patient variables and AR (P > 0.05). AR after THA/TKA was an observed phenomenon; however, larger trials are required to determine the clinical consequences of AR and to guide prophylaxis strategies in this population.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130751","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

Early glucocorticoid withdrawal in severe ANCA-associated vasculitis treated with combination cyclophosphamide and rituximab: a single-centre case series. 环磷酰胺和利妥昔单抗联合治疗严重anca相关性血管炎的早期糖皮质激素停药：单中心病例系列

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-22 DOI: 10.1111/imj.70212

Tania Salehi, Karthik Venkataraman, Jarrad Hopkins, John Lau, Philip Clayton, Joanna Tieu, Chen Au Peh

引用次数: 0

Not all hyperglycaemia in hospitalised pneumonia is created equal. 并非所有住院肺炎患者的高血糖都是相同的。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-22 DOI: 10.1111/imj.70208

Cherie Choong, Megan Dharma, Rahul D Barmanray

{"title":"Not all hyperglycaemia in hospitalised pneumonia is created equal.","authors":"Cherie Choong, Megan Dharma, Rahul D Barmanray","doi":"10.1111/imj.70208","DOIUrl":"https://doi.org/10.1111/imj.70208","url":null,"abstract":"Community-acquired pneumonia (CAP) remains a major cause of hospitalisation and mortality worldwide. Corticosteroid therapy reduces 30-day mortality in hospitalised patients with CAP but nearly doubles the risk of hyperglycaemia. It may appear that hyperglycaemia can arise from distinct mechanisms: \"inflammation-mediated hyperglycaemia,\" which signals disease severity and predicts worse outcomes, and \"corticosteroid-induced hyperglycaemia,\" a side effect of beneficial treatment that may appear not to increase mortality risk. Evidence from COVID-19 cohorts supports this distinction, showing that hyperglycaemia following corticosteroid use correlates with disease severity and longer hospital stays but not with increased mortality. Early glycaemic control reduces complications such as healthcare-associated infections in the context of hyperglycaemia due to inflammatory mediators and in the absence of corticosteroids, yet its role in corticosteroid-induced hyperglycaemia remains unclear. The lack of a standardised definition of hyperglycaemia further complicates research and clinical management. Understanding the differential impacts and optimal glucose targets for these potential hyperglycaemia subtypes is critical. Future research should focus on evaluating the effects of glucose control on outcomes in corticosteroid-associated hyperglycaemia, determining optimal glycaemic thresholds and evaluating suitable therapeutic management strategies in this clinical context.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113084","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

What does 'complex' mean for the general medicine team? Exploring the characteristics, outcomes and clinician perspectives of complex patients: an observational cohort and cross-sectional survey. 对于全科医学团队来说，“复杂”意味着什么？探讨复杂病人的特点、结局和临床医生的观点：一项观察性队列和横断面调查。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-09-15 DOI: 10.1111/imj.70203

Elena Gerstman, Jennifer Jones, Chris Michael, Sue Berney, Karin Thursky, David J Berlowitz

{"title":"What does 'complex' mean for the general medicine team? Exploring the characteristics, outcomes and clinician perspectives of complex patients: an observational cohort and cross-sectional survey.","authors":"Elena Gerstman, Jennifer Jones, Chris Michael, Sue Berney, Karin Thursky, David J Berlowitz","doi":"10.1111/imj.70203","DOIUrl":"https://doi.org/10.1111/imj.70203","url":null,"abstract":"Background: Patients who are 'complex' experience poorer outcomes during and after hospitalisation. At our health service, patients identified as complex are referred to a specialist transdisciplinary allied health pathway, but this process is subjective and predominantly based on clinical judgement.Aims: To characterise patients referred to the complex pathway by describing their characteristics and outcomes and by developing a list of words clinicians associate with complexity to generate an electronic health record (EHR) complexity phenotype.Methods: We performed a retrospective observational cohort study of all patients admitted to General Medicine at a metropolitan hospital in Melbourne over a 10-month period and a cross-sectional survey of clinicians (allied health, medical, nursing). We compared the demographics, clinical features and outcomes of the complex patients to their non-complex peers. Cohort outcomes included length of stay, readmissions, discharge destination, mortality and adverse event rates. The survey data scored the likelihood of words suggesting complexity from a clinician's perspective.Results: In the cohort (n = 3061), 328 (11%) were complex. Complex patients were older, frail and more multimorbid. This group stayed longer in hospital, and more required rehabilitation, with increased mortality and readmissions (P < 0.01). Eighty clinicians (allied health (50%), medical (31%) and nursing (19%)) generated a library of 18 words that described a complex patient.Conclusion: Frailty, age and high hospital utilisation were associated with complexity across both studies. Combining clinical and demographic data with natural language processing of complexity words may allow prospective digital prediction of patients likely to benefit from complex care pathways.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064590","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