Internal Medicine Journal最新文献

{"title":"Prevalence of vasculitis, systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, idiopathic inflammatory myopathies and spondyloarthritis in Australia: a systematic review and meta-analysis.","authors":"L Roper, E Cameron, T Yu, N Li, M Parker, N Nassar, M Nikpour","doi":"10.1111/imj.70210","DOIUrl":"https://doi.org/10.1111/imj.70210","url":null,"abstract":"<p><strong>Background: </strong>Systemic autoimmune rheumatic diseases (SARDs), including vasculitis, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIM), spondyloarthritis (SpA), Sjogrens disease (SjD) and mixed connective tissue disease (MCTD), are rare but associated with substantial morbidity and healthcare burden. Their clinical heterogeneity and diagnostic complexity pose challenges for epidemiological study.</p><p><strong>Objective: </strong>To summarise Australian data on the incidence or prevalence of the SARDs listed above.</p><p><strong>Methods: </strong>Scientific databases were searched in July 2024. Studies reporting SARD incidence or prevalence in the general Australian population were included. Where three or more studies of the same disease existed within a comparable population, which were not at high risk of bias (Hoy Tool), a random effects model was fitted.</p><p><strong>Results: </strong>From 1357 publications, 58 were included, on: vasculitis (16), SLE (14), RA (10), SSc (nine), IIM (six) and SpA (three), with none on SjD or MCTD identified. Meta-analysis was possible in ANCA-associated vasculitis (AAV) (incidence 10.80 per million person-years), SLE (prevalence 57.86 per 100 000), lupus nephritis (prevalence 11.20 per 100 000, incidence 1.02 per 100 000 person-years), SSc (prevalence 25.58 per 100 000), IIM (incidence 9.96 per million person-years) and inclusion body myositis (prevalence 27.73 per million). Data were limited for paediatric populations and specific at-risk groups (e.g. Australians of Asian heritage).</p><p><strong>Conclusion: </strong>Australia may have above-average prevalence of SLE and SSc and geographic variation in SSc and AAV. Key research gaps include: (1) sparse data for non-AAV vasculitis, RA, SpA, SjD, MCTD and children; (2) limited validated algorithms to identify SARDs in administrative health data; and (3) a need for large-scale spatial studies to detect disease clusters.</p>","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":"145069365","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":"Psychosocial well-being of adolescents and young adults living with chronic illness.","authors":"Annabel Cavanagh, Sam Adhikary, Simon Denny","doi":"10.1111/imj.70198","DOIUrl":"https://doi.org/10.1111/imj.70198","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYA) living with chronic illness face substantial psychosocial challenges during key developmental transitions, and increasing numbers now receive care in adult hospitals. Yet adult services are often not youth-appropriate, and comparative data on psychosocial burden across disease groups in these settings are needed to guide service planning.</p><p><strong>Aim: </strong>To describe the psychosocial characteristics of AYA with chronic illness attending different specialist outpatient clinics to better understand their psychosocial well-being and burden of illness experienced by this cohort.</p><p><strong>Methods: </strong>AYA in eight different specialist outpatient clinics between 2013 and 2020 completed self-report questionnaires that examined demographic, psychosocial, general health and quality-of-life variables. Latent class analysis was used to identify participant psychosocial and mental health profiles, which were compared across clinics.</p><p><strong>Results: </strong>A total of 452 AYA were recruited from inflammatory bowel disease, cystic fibrosis, rheumatology, phenylketonuria (PKU), cranio-maxillofacial (CMF), renal transplant, diabetes and alcohol and other drugs (AOD) clinics. Participants were between 16 and 25 years of age, with similar proportions of males and females. Overall, latent class analysis revealed three distinct groups of participants based on their psychosocial and mental health profiles: thriving (42.6%), coping (36.5%) and stressed (20.8%). These proportions varied markedly by clinic, with the highest proportion of stressed young people found in the AOD service (88%), followed by rheumatology (51.6%) and renal transplant (31.2%). Conversely, most patients in PKU (57.1%) and CMF (58.6%) were classed as thriving.</p><p><strong>Conclusion: </strong>While the majority of AYA utilising specialist outpatient services were classed as thriving, significant numbers were struggling and reported high levels of psychosocial stress and challenges in engaging in their communities. These findings varied significantly by clinic and are therefore important in planning services and support for young people living with chronic illness and disability.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040086","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":"Temporal trends in gender-affirming hormone therapy initiation: evidence from whole-of-population Australian administrative data.","authors":"Karinna Saxby, Brendan J Nolan","doi":"10.1111/imj.70194","DOIUrl":"https://doi.org/10.1111/imj.70194","url":null,"abstract":"<p><p>Using longitudinal national prescribing data, we estimated the number of transgender and gender-diverse individuals initiating gender-affirming hormone therapy (GAHT) from 2013 to 2024 in Australia. Between 2013 and 2024, 11 883 individuals initiated testosterone-based GAHT and 20 358 initiated oestrogen-based GAHT. Initiation rose from 1118 in 2013 to 5135 in 2024, with a growing share accessing testosterone-based GAHT over time. The mean age at initiation also fell from 50 years in 2013 to 26 years in 2024. Our findings align with international trends, suggesting increasing demand among younger populations. This highlights the need for specialised, accessible gender-affirming care in Australia and underscores the importance of improved data collection to inform health policy and clinical practice.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029773","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":"Tenofovir-induced Fanconi syndrome causing type 2 renal tubular acidosis initially mistaken as euglycaemic ketoacidosis.","authors":"Andrew Dermawan, Awf Shaban, Revathy Manickavasagar","doi":"10.1111/imj.70196","DOIUrl":"https://doi.org/10.1111/imj.70196","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023275","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":"Association of bushfire-associated air pollution and giant cell arteritis in the Australian Capital Territory and surrounding regional New South Wales.","authors":"Darren Chyi Hsiang Kong, Marissa Nichole Dominique Lassere, Annamma Kochummen Dorai Raj, Barry Austin Kane","doi":"10.1111/imj.70195","DOIUrl":"https://doi.org/10.1111/imj.70195","url":null,"abstract":"<p><strong>Background: </strong>Giant cell arteritis (GCA) has possible links to environmental factors such as air pollution.</p><p><strong>Aims: </strong>We examined whether bushfire-related air pollution during the 2019-2020 Australian bushfires was associated with GCA incidence.</p><p><strong>Methods: </strong>We retrospectively analysed 29 biopsy-confirmed cases (2018-2021) and matched onset dates with air pollutant levels. A bidirectional time-stratified case-crossover design was performed using conditional logistic regression.</p><p><strong>Results: </strong>Non-significant associations were demonstrated between pollutant exposure and GCA, with inconsistent results across air quality stations.</p><p><strong>Conclusions: </strong>No clear link was found. Further studies with larger samples and longer follow-up are needed.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992448","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":"Treatment of sleep apnoea in patients: consider various types of continuous positive airway pressure devices for optimal management","authors":"Jennifer E. Geller,&nbsp;Gloria A. Bachmann","doi":"10.1111/imj.70193","DOIUrl":"10.1111/imj.70193","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1591-1592"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952697","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 relevance of nailfold capillaroscopy in interstitial lung disease","authors":"Angelo Nigro","doi":"10.1111/imj.70162","DOIUrl":"10.1111/imj.70162","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1597-1599"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952610","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":"Urgent call to action: mobilising physicians and the medical workforce to address treatment of medical instability from eating disorders","authors":"Patrick Russell,&nbsp;Elizabeth Potter,&nbsp;Gabriella Heruc,&nbsp;Jemma Anderson","doi":"10.1111/imj.70189","DOIUrl":"10.1111/imj.70189","url":null,"abstract":"&lt;p&gt;Eating disorders remain understudied, underfunded and under addressed despite their substantial impact on public health and the economy. These disorders cost Australia an estimated $66 billion annually,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; far surpassing the costs of obesity ($12 billion)&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and even stroke ($32 billion).&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Yet research into eating disorders remains disproportionately low (Fig. 1).&lt;/p&gt;&lt;p&gt;The rising prevalence of eating disorders has been well documented in the medical literature&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; and lay press alike. Yet at most Australian hospitals, the sequence of care for the medically unstable inpatient admitted with an eating disorder has not led to a commensurate rise in improved outcomes.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;To begin addressing this apparent paradox, we propose three broad goals to make inroads leading to better inpatient care and outcomes.&lt;/p&gt;&lt;p&gt;Proactive medical leadership begins at the bedside. Inpatient mortality for eating disorders might not equal that of stroke or sepsis, but the standardised mortality ratio for anorexia nervosa is 5.86 for females aged 15–24 years&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; and as high as 21.7 even years after treatment.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; Often these patients spend time in hospital primarily for nutritional therapy. We do not delay the administration of antibiotics to people with sepsis; a similar urgency about nutritional resuscitation, including placement of a nasogastric tube for those who need it and accelerating the initiation of tube feeding, could reduce unwanted time in hospital. Accelerating the rate of refeeding may result in better weight gains.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; A mature and effective multidisciplinary team (MDT) can work together with a medically unstable inpatient to build goals that are sensitive to culture and mental health and, where possible, involve family.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Medical leadership extends beyond the bedside by connecting and engaging a MDT of nursing, psychiatry and dietetics to improve inpatient care. Proactive medical leadership also includes multidisciplinary involvement in the research enterprise from the moment of admission and life-sustaining hospital bedside care. Multidisciplinary care is a national standard, but it remains unclear how many hospitals admitting medically unstable patients with eating disorders conduct formal MDT meetings or how many admissions per year would make regular meetings justified. An effective MDT meeting&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; fosters a collaborative spirit and enables a sense of shared care and responsibility. It is also an opportunity for cross-disciplinary learning and can reduce stigmatising attitudes towards patients.&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; The Australia &amp; New Zealand Academy for Eating Disorders (ANZAED) Clinical Practice Standards for eating disorder treatment recommend team members should have clear roles and communication pathways t","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1423-1426"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952768","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":"Critical review of long-term outcomes in subcutaneous implantable cardioverter-defibrillator therapy","authors":"Brijesh Sathian,&nbsp;Hanadi Al Hamad,&nbsp;Javed Iqbl","doi":"10.1111/imj.70192","DOIUrl":"10.1111/imj.70192","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1602-1603"},"PeriodicalIF":1.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952629","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":"Out-of-hours clinical work of junior doctors: perspectives of an internal medicine resident","authors":"Isaac KS Ng","doi":"10.1111/imj.70191","DOIUrl":"10.1111/imj.70191","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1604-1605"},"PeriodicalIF":1.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952777","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}