Internal Medicine Journal最新文献_第5页

Clindamycin intravenous to oral switch automatic notifications: a pilot study 克林霉素静脉到口服切换自动通知：一项试点研究。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-20 DOI: 10.1111/imj.70172

Shrirajh Satheakeerthy, Sal Ging Vong, Rory Hannah, Melissa Teo, Christina Gao, Brandon Stretton, Aashray Gupta, Joshua Kovoor, Samuel Gluck, Toby Gilbert, Stephen Bacchi

引用次数: 0

Neurological manifestations of chronic graft versus host disease. 慢性移植物抗宿主病的神经学表现。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-19 DOI: 10.1111/imj.70184

Tal Koren, Alice Kwok, William Stevenson, Kate Ahmad, Joseph Nogajski, John Parratt, Ian Kerridge, Karl Ng

{"title":"Neurological manifestations of chronic graft versus host disease.","authors":"Tal Koren, Alice Kwok, William Stevenson, Kate Ahmad, Joseph Nogajski, John Parratt, Ian Kerridge, Karl Ng","doi":"10.1111/imj.70184","DOIUrl":"10.1111/imj.70184","url":null,"abstract":"Introduction: Allogeneic haemopoietic stem cell transplant (allo-HSCT) is an established therapy for many malignant and non-malignant conditions, with an increasing number of uses and indications in recent decades. Complications including graft versus host disease (GvHD) carry significant morbidity and mortality. Chronic GvHD can affect multiple organs, including skin, gastrointestinal, respiratory and eyes. Neurological involvement is less common and can be a diagnostic and therapeutic challenge for patients and clinicians.Methods: A retrospective analysis was conducted of patients who underwent allo-HSCT for a haematological malignancy with an established diagnosis of chronic GvHD at a major Australian institution.Results: Out of 455 allo-HSCT cases, 228 (50%) had chronic GvHD, seven (3.1%) of which were identified to have neurological complications. Four cases, each consisting of myasthenia gravis, Bickerstaff brainstem encephalitis, acute disseminated encephalomyelitis and inflammatory meningitis, were selected to illustrate peripheral and central neurological manifestations of chronic GvHD. Presentations, management and outcomes were discussed and contrasted to similar cases available in the literature.Conclusion: Chronic GvHD infrequently presents with neurological manifestations. Understanding the similarities and differences of these and their idiopathic counterparts allows an enhanced understanding of their pathophysiology within the context of GvHD, as well as some significant differences to conventional management of these neurological conditions.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873018","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

Thiazide-induced hyponatraemia: distinguishing hypovolaemic and euvolaemic subtypes to guide management strategies. 噻嗪类药物引起的低钠血症：区分低血容量和高血容量亚型以指导管理策略。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-19 DOI: 10.1111/imj.70175

Yeung-Ae Park, Megan Dharma, Mervyn Kyi, Douglas Johnson, Spiros Fourlanos

{"title":"Thiazide-induced hyponatraemia: distinguishing hypovolaemic and euvolaemic subtypes to guide management strategies.","authors":"Yeung-Ae Park, Megan Dharma, Mervyn Kyi, Douglas Johnson, Spiros Fourlanos","doi":"10.1111/imj.70175","DOIUrl":"10.1111/imj.70175","url":null,"abstract":"Hyponatraemia is the most prevalent electrolyte imbalance observed in acute clinical settings, occurring in up to 30% of inpatients. Thiazide-induced hyponatraemia (TIH) is common, accounting for approximately one quarter of hyponatraemia cases among hospitalised patients. TIH presentations may occur with either a diuretic-induced volume depletion and subsequent hypovolaemic hyponatraemia or with a syndrome of inappropriate antidiuresis (SIAD)-like presentation with euvolaemic hyponatraemia (which is more common). Hyponatraemia is associated with prolonged hospital length of stay and greater risk of readmission and, hence, a significant driver of additional inpatient healthcare costs. Similarly, TIH can lengthen hospital stay, underscoring the importance of early and accurate differentiation between its subtypes to guide management. Thiazides induce diuresis by inhibiting the sodium-chloride cotransporter in the distal convoluted tubule of the kidneys, thus leading to natriuresis, increased urinary chloride, aquaresis and mild volume depletion. However, thiazides can lead to a compensatory euvolaemic state through various mechanisms. Discriminating hypovolaemic from euvolaemic presentations can be challenging when using traditional approaches to assessing and managing hyponatraemia. Volume status assessment by physical examination can be unreliable, and since thiazides promote natriuresis, urine sodium levels provide limited diagnostic value. Thus, assessing serum (sodium, potassium, chloride) and urine (chloride, potassium) biochemistry in greater detail is useful for distinguishing between the two subtypes of TIH, which have different management strategies. We present a narrative review of TIH and propose a practical diagnostic approach to assist in clinical judgement for early and accurate determination of the subtypes, enabling prompt management.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882827","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

Evaluation of a weight management service in the Northern Territory, Australia. 对澳大利亚北领地体重管理服务的评价。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-13 DOI: 10.1111/imj.70180

Anna J Wood, Olivia Fox, Annabel Thallon, Seileshia Calma-Goodrem, Kelly Taylor, Louise J Maple-Brown, Kaspar Willson, Diana MacKay

{"title":"Evaluation of a weight management service in the Northern Territory, Australia.","authors":"Anna J Wood, Olivia Fox, Annabel Thallon, Seileshia Calma-Goodrem, Kelly Taylor, Louise J Maple-Brown, Kaspar Willson, Diana MacKay","doi":"10.1111/imj.70180","DOIUrl":"https://doi.org/10.1111/imj.70180","url":null,"abstract":"Background: There is a growing demand for specialist weight management services across Australia, yet publicly funded weight management services are lacking, with limited data on the effectiveness of these services.Aims: To evaluate the effectiveness of a regional specialist weight management service on weight loss and weight loss maintenance, and to determine attrition rates of this service.Methods: A prospective evaluation of adults who attended the publicly funded Top End Weight Management Service, with their first appointment between August 2021 and August 2023 and follow-up period of at least 12 months. Wilcoxon signed rank test was used to analyse changes in absolute and percent body weight between the initial visit and at 3, 6 and 12 months.Results: Of the 81 patients, 40% identified as Aboriginal and/or Torres Strait Islander, 59 (73%) were still attending the service at 3 months, 48 (59%) at 6 months and 39 (48%) at 12 months. Median weight change at 3 months was -6.0 kg and -4.7%. Median weight change at 6 months was -7.9 kg and -5.6%, and at 12 months was -11.3 kg and -8.5% for participants in the weight management service. At 12 months, 62% achieved at least 5% weight loss and 44% achieved at least 10% weight loss.Conclusions: This study demonstrated that clinically meaningful weight loss and associated weight loss maintenance were achievable for a select population through a weight management service.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834971","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

Evaluation of interventions for trauma care in older adults: a consensus study. 评估老年人创伤护理干预措施：一项共识研究。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-13 DOI: 10.1111/imj.70171

Noha Ferrah, Lucas Neumaier, Joseph Ibrahim, Belinda Gabbe, Ben Beck, Peter Cameron

{"title":"Evaluation of interventions for trauma care in older adults: a consensus study.","authors":"Noha Ferrah, Lucas Neumaier, Joseph Ibrahim, Belinda Gabbe, Ben Beck, Peter Cameron","doi":"10.1111/imj.70171","DOIUrl":"https://doi.org/10.1111/imj.70171","url":null,"abstract":"Background: Trauma care of older adults is an important and growing public health issue. Countries such as the United States and United Kingdom have published best-practice guidelines on the management of older trauma patients. In Australia, there are no such guidelines. Australian guidelines are needed as there are unique contextual challenges, including low population density and large distances between the site of injury and where treatment is administered.Aims: To determine which interventions for managing older trauma patients should be prioritised for inclusion in national guidelines.Methods: A consensus method with two survey rounds was conducted with a range of health professionals involved in delivering trauma care for older adults. In round 1, participants were asked which of 28 interventions should be included in national guidelines. Consensus was defined as ≥80% agreement. In round 2, participants ranked interventions in order of priority for inclusion in guidelines. Interventions were classified into pre-hospital care, in-hospital initial assessment, inpatient care, transition care and education.Results: A total of 32 and 25 participants completed rounds 1 and 2 of the survey respectively. Of 28 interventions proposed for national guidelines, 15 reached consensus. Key priority interventions included geriatric-specific triage, documented goals of care, trauma team activation criteria, multidisciplinary geriatric care and training modules in older trauma care.Conclusions: This study identified 15 interventions that trauma clinicians agreed should be considered for inclusion in guidelines for the management of older adult trauma. Given the burden of older adult trauma, a national consensus guideline should be prioritised and a working group formed.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834972","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

Effective real-world outcomes of remdesivir provided under compassionate access for moderate/severe COVID-19 in Australia. 在澳大利亚，瑞德西韦在同情获取下为中/重度COVID-19提供了有效的现实结果。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-11 DOI: 10.1111/imj.70173

Robert Stolz, Alice Liu, Jonathan Darby, Marion Kainer, Stephen Guy, Leong Shuen Loo, Craig Aboltins, Pann Ei Wynn, Patrick G P Charles, Kumar Visvanathan, Peter Kelley, Tony Korman, Nicole Gilroy, Joe Sasadeusz

{"title":"Effective real-world outcomes of remdesivir provided under compassionate access for moderate/severe COVID-19 in Australia.","authors":"Robert Stolz, Alice Liu, Jonathan Darby, Marion Kainer, Stephen Guy, Leong Shuen Loo, Craig Aboltins, Pann Ei Wynn, Patrick G P Charles, Kumar Visvanathan, Peter Kelley, Tony Korman, Nicole Gilroy, Joe Sasadeusz","doi":"10.1111/imj.70173","DOIUrl":"https://doi.org/10.1111/imj.70173","url":null,"abstract":"Background: Remdesivir is a nucleotide analogue with in vitro activity against SARS-COV-2. Clinical trial data from the ACTT-1 randomised clinical trial demonstrated improved time to clinical recovery. The effectiveness and safety in a real world setting in Australia are unknown.Aim: To evaluate real-world clinical outcomes in an Australian setting.Methods: Retrospective chart review in a tertiary care setting of patients who received remdesivir under compassionate access in 10 Australian hospitals between July and December 2020. The primary outcome was time to recovery, as defined on an ordinal scale by discharge or hospitalisation no longer requiring any acute medical care. Secondary outcomes including 28-day mortality were also measured and compared to data from ACTT-1.Results: Data were collected on 220 patients. The average age was 61 years (range 23-96); 76 (34%) patients had diabetes, 45 (20%) had pre-existing lung disease, and 21 (9%) were immunosuppressed; 214 (96%) patients were hypoxic at any point during the admission, and 51 (22%) patients required mechanical ventilation. Mean duration of symptoms to commencement of remdesivir was 7 days (range 0-14), while 213 (95%) received glucocorticoids. Median time to improvement on remdesivir was 4 days, compared to 7 days in patients receiving remdesivir in ACTT-1. The 28-day mortality was 9%, compared to 11% in ACTT-1.Conclusion: Clinical recovery and mortality with remdesivir in a real-world setting were at least comparable to randomised clinical trial data, confirming effectiveness in this setting. Use of adjunctive glucocorticoids in this cohort likely contributed to the improved outcomes.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816460","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

Artificial intelligence-generated deepfakes in healthcare and biomedical research: major adverse implications for patients, public and professionals 医疗保健和生物医学研究中人工智能产生的深度造假：对患者、公众和专业人士的重大不利影响。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-07 DOI: 10.1111/imj.70152

Alicia J. Jenkins, Jonathan E. Shaw, Assam El-Osta, Leon Tribe, David N. O'Neal, Michael Spiegel, John P. Greenwood, Neale Cohen

引用次数: 0

Argyria resulting from colloidal silver ingestion, a differential in modern-day practice 银中毒由摄入银胶体引起，在现代实践中有所不同。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-06 DOI: 10.1111/imj.70163

Evan Browne, Jacob Fairhall, Richard Day

引用次数: 0

Publicly accessible reporting of tangible outcomes for government-funded research should be mandated 政府资助的研究的实际成果应被公开报告。

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-05 DOI: 10.1111/imj.70165

Brandon Stretton, Benjamin Cook, Christina Gao, Daniel Jesudason, Joshua Kovoor, Aashray Gupta, Weng Onn Chan, Stephen Bacchi

引用次数: 0

Management of patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplantation: position statement of the Medical and Scientific Advisory Group of Myeloma Australia. 有资格接受自体干细胞移植的新诊断多发性骨髓瘤患者的管理：澳大利亚骨髓瘤医学和科学咨询小组的立场声明

IF 1.5 4区医学

Internal Medicine Journal Pub Date : 2025-08-04 DOI: 10.1111/imj.70148

Georgia McCaughan, Hayley Beer, Christian Bryant, P Joy Ho, Tracy King, Cindy Lee, Peter Mollee, H Miles Prince, Andrew Spencer, Dipti Talaulikar, Kate Vandyke, Nicholas Weber, Angelina Yong, Simon Harrison, Hang Quach

引用次数: 0