Internal Medicine Journal最新文献

{"title":"Online tool for cross-sectional and longitudinal comparison of socio-economic status indices based on postcodes in Australia.","authors":"Andrzej S Januszewski, Rachel L O'Connell, Liping Li, David R Sullivan, Alicia J Jenkins, Anthony C Keech","doi":"10.1111/imj.70117","DOIUrl":"10.1111/imj.70117","url":null,"abstract":"<p><strong>Background: </strong>Socio-economic status (SES) is strongly associated with health outcomes, yet it remains relatively difficult to measure, particularly for longitudinal comparisons.</p><p><strong>Aim: </strong>We have developed an interactive online tool (available at bit.ly/SEIFA-POA) that facilitates SES assessment based on postcodes (POA).</p><p><strong>Methods: </strong>By utilising percentiles of socio-economic indices for areas (SEIFA) derived from postcode-based rankings across Australia, this tool enables comparisons of SEIFA indices provided by the Australian Bureau of Statistics (ABS) censuses from 1986 through to 2021. A percentile-based methodology preserves the relative socio-economic position of areas over time, thereby circumventing the methodological inconsistencies inherent in SEIFA calculations across different census periods. The tool simplifies SES assessment, offering researchers and policymakers a practical solution for both cross-sectional and longitudinal studies.</p><p><strong>Results: </strong>In 6051 participants of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial from Australia, we demonstrated that favourable SES is associated with a lower frequency of vascular complications in the participants' medical history. The absence of an observed association between SES and on-trial complications may be attributed to the relatively short 5-year average time horizon of the analysis.</p><p><strong>Conclusion: </strong>Our SES assessment tool provides a more nuanced understanding of SES disparities and their implications for health and well-being.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336496","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":"Melanoma update: is a cure now in sight?","authors":"Samrin Liaqat, Muhammad Adnan Khattak","doi":"10.1111/imj.70085","DOIUrl":"https://doi.org/10.1111/imj.70085","url":null,"abstract":"<p><p>Melanoma, one of the most aggressive skin cancers, poses a significant global health concern due to its high metastatic potential and resistance to conventional treatments. This review explores recent advancements in melanoma treatment, particularly the impact of targeted therapies and immunotherapies which have significantly extended survival and improved the quality of life for advanced melanoma patients. Additionally, the innovative combination and sequential strategies, with immune checkpoint inhibitors and cancer vaccines or targeted therapies against BRAF mutations, mark a promising direction. Recent advances in tumour infiltrating lymphocytes and oncolytic virus therapy and personalised cancer vaccine development are also covered, highlighting the role of precision medicine in achieving tailored, effective treatments. Despite these advancements, challenges persist, including drug resistance and the need for reliable biomarkers to predict treatment response and select patients. This review underscores the ongoing efforts in research and clinical trials to refine therapeutic strategies, improve treatment outcomes for a larger population detection and, ultimately, advance towards a cure for melanoma.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325592","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 and reporting quality of Thoracic Society of Australia and New Zealand clinical guidance documents^†.","authors":"William C L Soon, Yvonne Ng, Daniel Seow, Arwel W Jones, Yet H Khor","doi":"10.1111/imj.70090","DOIUrl":"https://doi.org/10.1111/imj.70090","url":null,"abstract":"<p><p>The Thoracic Society of Australia and New Zealand (TSANZ) is the leading Australasian professional society for respiratory medicine that develops clinical practice guidelines and position papers to advance lung health through improved clinical care and research efforts. Published TSANZ clinical guidance documents were identified from the online society repository until March 2023. Each document was independently scored using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklists for methodological and reporting quality respectively. Twenty-eight position papers and seven clinical practice guidelines were evaluated. The median overall methodological quality score for the AGREE II checklist was four out of a maximum of seven (interquartile range (IQR) 3.5-4.75). The majority of documents (97%) were recommended for use with or without modifications. The median overall reporting rate using the RIGHT checklist was 46% (IQR 40-54). Low-scoring items were rigour of evidence synthesis, focus on clinical implementation, conflict of interest declaration and clarity of methodology. Clinical practice guidelines scored significantly higher overall reporting quality than position papers (57% vs. 43%, P = 0.05), but not for the methodological quality scores (median number of high-scoring domains (>70%): 2 vs. 1, P = 0.13). Documents developed with methodologist involvement had significantly increased reporting (71% vs. 43%, P = 0.02) and methodological quality (median high-scoring domains: 4 vs. 1, P = 0.007), compared to those without. Based on AGREE II, most TSANZ clinical guidance documents are recommended for use, or for use with modifications. Applicability, stakeholder involvement and conflict of interest declarations are identified as areas for improvement in future documents.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325593","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":"Clearing the air: smoking status in kidney transplantation assessment – a question of risk or equity?","authors":"Nasir Ali Shah,&nbsp;Kenneth Yong","doi":"10.1111/imj.70105","DOIUrl":"10.1111/imj.70105","url":null,"abstract":"&lt;p&gt;Over the past two decades, the number of individuals receiving treatment for end-stage kidney disease (ESKD) in Australia has doubled. Although the prevalence of kidney transplantation also increased twofold during this period,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; the kidney transplant waiting list has remained long due to persistent disparities between organ supply and demand. Between 2018 and 2023, the national median waiting time for kidney transplantation increased from 2.1 to 2.5 years.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; As a result, 1330 patients remained on the kidney transplant waiting list in 2023.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Amid this growing need, the eligibility of active smokers has remained a subject of ongoing debate.&lt;/p&gt;&lt;p&gt;In this issue of the &lt;i&gt;Internal Medicine Journal&lt;/i&gt; in a retrospective study conducted within a local health district in New South Wales (NSW) Australia, Hazim &lt;i&gt;et al&lt;/i&gt;. examined a cohort of 333 patients receiving maintenance dialysis, of whom ~25% were identified as current smokers.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Among the overall cohort, 150 individuals were referred for transplant assessment. Smoking was cited as the primary reason for exclusion from the transplant waitlist in 14.4% of cases. Of the 89 patients who were current smokers, 48 were not referred for transplant assessment. Within this subgroup, smoking status alone accounted for exclusion in 10 cases, while both smoking and the presence of comorbidities contributed to exclusion in 38 cases. The outcomes of smokers who did receive pre-transplant assessment were not discussed. This study found that patients who were active smokers tended to be younger (47.8 years vs. 52.1 years) and had a lower burden of comorbid conditions compared to those excluded for other reasons. Specifically, individuals excluded due to smoking had a lower prevalence of diabetes mellitus, coronary artery disease, peripheral vascular disease and heart failure. In addition to the retrospective analysis, the study incorporated a national survey of Australian transplant units, which revealed that approximately 30% of centres did not exclude patients from waitlisting solely because of active smoking. The survey also identified substantial variability in clinical practice related to the assessment and management of smoking, including differences in the use of self-reported smoking status versus biochemical verification (serum cotinine measurements) and assistance for smoking cessation. The authors concluded that rigid smoking policies may inadvertently exclude individuals who would otherwise be suitable transplant candidates, potentially contributing to inequities in access to care – particularly among populations with lower socioeconomic status or indigenous background.&lt;/p&gt;&lt;p&gt;It is well established that tobacco use is a leading and preventable cause of mortality in the general population. In the Global Burden of Disease study, there were an estimated 6.18 million (9.1%) deaths attributable to smoking","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"882-884"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225346","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":"Intravenous administration of ferric derisomaltose is associated with a higher incidence of infusion reactions than ferric carboxymaltose, and unaffected by dilution volume.","authors":"Sarah Lucas, Ayushi Chauhan, Ciaran Hurley, Calvin Xu, Catherine Yu, Katrina Tan, Sarah Taylor, Mani Suleiman, Teresa Leung, Mayur Garg","doi":"10.1111/imj.70100","DOIUrl":"https://doi.org/10.1111/imj.70100","url":null,"abstract":"<p><strong>Background: </strong>The incidence of and risk factors for infusion-related reactions to intravenous iron formulations remains poorly characterised. This study aimed to compare the rates of infusion reactions in patients receiving ferric derisomaltose (FDI) compared to ferric carboxymaltose (FCM), as well as across different dilutions of FDI.</p><p><strong>Aims: </strong>To compare the rates of infusion reactions in patients receiving ferric derisomaltose (FDI) compared to ferric carboxymaltose (FCM), as well as across different dilutions of FDI.</p><p><strong>Methods: </strong>This was a single tertiary centre retrospective matched cohort study of patients who received FDI or FCM between January 2022 and May 2023. Reactions were classified as Fishbane or hypersensitivity and characterised by severity using the Ring and Messmer classification.</p><p><strong>Results: </strong>A total of 660 patients (330 age- and sex-matched patients who received FDI and FCM, respectively) were included. Hypersensitivity reactions occurred in 34 of 330 (10.3%) patients receiving FDI infusions compared to eight of 330 (2.4%) patients receiving FCM (odds ratio (OR), 4.62 (95% confidence interval (CI), 2.10-9.78), P < 0.0001). All reactions to FCM and FDI were classified as mild to moderate except for one grade III reaction to FDI. There was no difference in the rate of reaction between patients receiving FDI diluted in 100 mL (18/165) compared to 250 mL (16/165) sodium chloride (OR, 1.14 (95% CI, 0.55-2.27), P = 0.86). A history of a reaction to an alternative iron formulation was associated with increased risk of infusion reactions (OR, 3.55 (95% CI, 0.67-18.97), P = 0.14) and increasing age was associated with reduced risk (OR, 0.96 (95% CI, 0.94-0.99), P = 0.02).</p><p><strong>Conclusion: </strong>Patients receiving FDI had a significantly higher risk of mild infusion reactions compared to those receiving FCM, with no difference across different dilution volumes of FDI.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225347","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":"Indigenous bronchiectasis assessment scale - the 'IBAS': a proposed new tool to assess bronchiectasis severity in adult Indigenous Australians.","authors":"Timothy Howarth, Lisa Sorger, Helmi Ben Saad, Payi L Ford, Subash S Heraganahally","doi":"10.1111/imj.70118","DOIUrl":"https://doi.org/10.1111/imj.70118","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of a comprehensive bronchiectasis severity assessment tool specific for Indigenous people that corrects for normative references established for the non-Indigenous population.</p><p><strong>Aims: </strong>An innovative bronchiectasis assessment tool is developed for use in adult Indigenous patients - the Indigenous bronchiectasis assessment scale '(IBAS)'.</p><p><strong>Methods: </strong>A total of 454 adult Indigenous Australian patients, with chest CT confirmed bronchiectasis diagnosed between 2011 and 2020, were included. Age, sex, residence location, body mass index, radiological findings, sputum microbiology, lung function parameters and medical comorbidities were utilised to predict 5-year all-cause mortality and 5-year hospitalisations. Scores of parameters with P < 0.20 from univariate Cox regressions were derived.</p><p><strong>Results: </strong>The resultant IBAS included age (<30, 30-50, 50-70 and 70+ years), urban residence, forced vital capacity (% predicted) (>50%, 30%-50% and <30%), right lower lobe involvement, history of Haemophilus spp., Pseudomonas spp., yeast spp. or Moraxella spp., 2-year respiratory condition hospitalisation history (<2, 2 and 3+ admissions), and comorbid chronic obstructive pulmonary disease, asthma and arterial hypertension. The maximum score was 18, with thresholds at 0-4 (mild, n = 78, 34.4%), 5-7 (moderate, n = 111, 48.9%) and ≥ 8 (severe, n = 38, 16.7%). The area under the curve for 5-year mortality was 0.743 (95% confidence interval (CI) 0.683, 0.803). The IBAS score demonstrated significant delineation in mortality between mild and moderate (moderate hazard ratio (HR) 3.45 (95% CI 1.57, 7.58)) and between moderate and severe (severe HR 2.43 (95% CI 1.45, 4.07)).</p><p><strong>Conclusion: </strong>The proposed IBAS tool could be of aid in assessing bronchiectasis severity in Indigenous patients.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208467","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":"Medicinal cannabis: is current use clinically justified?","authors":"Russ J Scott, Ian A Scott","doi":"10.1111/imj.70094","DOIUrl":"https://doi.org/10.1111/imj.70094","url":null,"abstract":"<p><p>Cannabis products are increasingly perceived and advertised as natural and safe treatments for a variety of conditions, including chronic non-cancer pain (CNCP). The number of prescriptions for medicinal cannabis (MC) currently averages >80 000 per month for >1 million Australians. Although over 800 different cannabis products are available to prescribe in Australia, only two are registered on the Australian Register of Therapeutic Goods and approved by the Therapeutic Goods Administration for specific clinical indications. Using treatment for CNCP as an example, evidence of efficacy across nine systematic reviews was inconsistent and/or of low quality and, with the exception of neuropathic pain, was unable to identify patient phenotypes in whom a specific type and dosing of cannabis product can reliably provide sustained symptomatic relief. Professional bodies do not endorse unregulated or first-line use of cannabis for CNCP. Harm from cannabis is under-reported but adverse effects include impaired cognitive function, dizziness, sedation, confusion, psychosis and arrhythmias, potentially more so in older patients. Healthcare professionals must inform patients of the significant limitations of current evidence of efficacy and safety for cannabis use in CNCP and other conditions and resist media and industry pressures for greater access to and prescribing of MC.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215728","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":"Critical appraisal of '\"Charge what you think you're worth\": a qualitative study exploring the gender pay gap in medicine and the role of price transparency'.","authors":"Javed Iqbal, Muna A Al-Maslamani","doi":"10.1111/imj.70109","DOIUrl":"https://doi.org/10.1111/imj.70109","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198990","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":"Two decades at the helm: it only seems like a few weeks","authors":"Jeff Szer","doi":"10.1111/imj.70122","DOIUrl":"10.1111/imj.70122","url":null,"abstract":"&lt;p&gt;&lt;i&gt;‘We are all interested in the future, for that is where you and I are going to spend the rest of our lives’. (Ed Wood, opening monologue from Plan 9 from Outer Space, among the worst (and hence possibly the best) movies ever made)&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;Hopefully, it has come as no surprise to readers of the &lt;i&gt;Internal Medicine Journal&lt;/i&gt; (IMJ) that I am no longer Editor-in-Chief. It is likely that my successor, Paul Bridgman has already done considerably more work than he was anticipating when he first thought about applying for the position. I have been offered the opportunity to put something in writing to muse on the past 20 years in the position and an additional 5 or 6 before that as the haematology editor of the journal. When my predecessor, Ed Byrne, AO, decided to move on to greater things even than this journal, he tapped me on the shoulder and encouraged me to go for it. I did not expect to be successful in the application, nor to have still been here in 2025.&lt;/p&gt;&lt;p&gt;What have I seen? During this period, the journal moved to its current publisher and the previous hard copy submission and editing system was quickly replaced. This caused more than a little consternation among some editors and the editorial office, but it happened; we were all trained and worked through multiple iterations while the journal continued to be published regularly. We ensured that there was a published issue every month from the usual 10 issues &lt;i&gt;per annum&lt;/i&gt;, which was the norm prior to that. We gradually improved the reach of the journal, with the help of the publisher and the increasing quality of submitted work, reflected in the impact factor and other metrics.&lt;/p&gt;&lt;p&gt;Every year, in my January editorial, I have sung the praises of our Editorial Manager, Virginia Savickis, and her assistants at various times, Louise Young-Wilson and Aparna Avasarala. I feel that despite two decades of such comments, I have failed to do them justice. Whatever positive feeling you may have gleaned from my previous comments, please multiply them exponentially and then add some. Without this team, there would have been no IMJ, certainly not of the quality we have come to expect.&lt;/p&gt;&lt;p&gt;I regret very little about my time in the chair. One regret that I do have is that we did not fight harder for some form of print publication being maintained. There are still some fellows and readers who prefer a hard copy of academic papers. While I regard myself as somewhat ahead of the curve as far as technology is concerned, I still prefer to review and correct manuscripts on paper. I feel that, for some reason (and there may be literature to support this, although I will not seek it out), my brain is more forgiving of errors on the screen than on paper. Unfortunately, the COVID-19 pandemic put an end to any possibility of even limited print publication, and we were all forced to wear that. We are, of course, not the only journal in the world to have gone down this path.&lt;/p&gt;&lt;p&gt;I would like to mak","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198992","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":"Successful treatment of Rosai-Dorfman disease in the era of targeted therapy","authors":"Trung Quang Ngo,&nbsp;Pranav Dorwal,&nbsp;Danielle Oh","doi":"10.1111/imj.70108","DOIUrl":"10.1111/imj.70108","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 6","pages":"1042-1044"},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198991","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}