Internal Medicine Journal最新文献

{"title":"A new chapter for the Journal","authors":"Paul Bridgman","doi":"10.1111/imj.70176","DOIUrl":"10.1111/imj.70176","url":null,"abstract":"<p>Those who read the pages at the front of each issue of the Journal will note that the college has been proudly publishing an academic journal since 1952. Those pages list the past editors-in-chief, among whom none is more distinguished than my immediate predecessor, Professor Jeff Szer. Jeff has been the longest-serving editor in the Journal's history, having taken the helm 20 years ago.</p><p>Over the 16 years I have worked under Jeff's leadership, I have admired his unwavering commitment to editorial independence and his impeccable command of the English language. As I now step into the role of editor-in-chief, I am determined to uphold the same editorial integrity Jeff championed. However, I must humbly admit that matching his mastery of grammar will be a challenge.</p><p>The hallmark of Jeff's leadership has been his unwavering support for his editorial board. He has never been less than 100% supportive of his editors. Editors are key to a journal such as ours. Many unseen and unpaid hours of work are invested by the editors for the benefit of us all.</p><p>Jeff also had a close and enduring working relationship with our editorial manager in Sydney, Virginia Savickis. Virginia continues in her role today. She is, in fact, the longest-serving employee of the college – a testament to her dedication and the continuity she brings to our operations. She has the added benefit of working with Louise Young-Wilson, whose technical skills at this particular time of transition for the Journal are an added blessing.</p><p>The Royal Australasian College of Physicians is a vital part of what is the <i>Internal Medicine Journal</i>. As the parent organisation, they bring stability and international recognition. The college has contributed to the recognition and indexing of the Journal by international bodies.</p><p>Of course, a journal is nothing without its readers and authors. Over the years, the publishing landscape has shifted. Authors have become increasingly central to the process, especially as universities have changed their funding models. Rather than paying for access to read journals, institutions now often pay publishers to make research open access. In parallel, the Journal has transitioned to an online-only format – a decision made by the college in support of environmental sustainability and in line with broader publishing trends.</p><p>I am excited about what lies ahead for the Journal. We aim to develop the Journal for and with the fellows of the college meeting their needs both as authors and as readers. For fellows and trainees of the college, this is your journal and it remains a vital point of connection with your college. Please be encouraged to email me at <span>[email protected]</span> with your comments and thoughts.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775285","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":"Time for a rethink? Discharge summary completion is often delayed and associated with increased readmission","authors":"Oliver Kleinig,&nbsp;Lewis Hains,&nbsp;Ashwin Murugappa,&nbsp;Samuel Gluck,&nbsp;Jarrod Marks,&nbsp;Toby Gilbert,&nbsp;Stephen Bacchi","doi":"10.1111/imj.70150","DOIUrl":"10.1111/imj.70150","url":null,"abstract":"<p>A retrospective review of 7185 South Australian discharge summaries revealed that 37.6% of discharge summaries were released at least a day after discharge, and per day of delay of <i>medical</i> discharge summary release, the chance of hospital 30-day readmission increased by 1.60% (<i>P</i> &lt; 0.001). Delays may be associated with the task being time-consuming. The workforce impact of junior doctor time and increased readmission rates favours interventions to change discharge summary workflows.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1575-1577"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033278","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":"Detection of phosphatidylethanol in an abstinent individual following blood transfusion.","authors":"Benedict Tan, Gerry Mac Quillan, David Joyce, Sam Salman","doi":"10.1111/imj.70153","DOIUrl":"https://doi.org/10.1111/imj.70153","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753265","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":"Severe dengue fever with secondary haemophagocytic lymphohistiocytosis","authors":"Robert S. O'Neill,&nbsp;Simran Dhugga,&nbsp;Harry Crane,&nbsp;John Moore","doi":"10.1111/imj.70164","DOIUrl":"10.1111/imj.70164","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 8","pages":"1412-1413"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753266","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":"How should glucocorticoid and mineralocorticoid replacement be optimised in a young patient with classic 21-hydroxylase congenital adrenal hyperplasia?","authors":"Stephanie Teasdale,&nbsp;Kriti Joshi,&nbsp;Tony Huynh,&nbsp;Louise S. Conwell","doi":"10.1111/imj.70174","DOIUrl":"10.1111/imj.70174","url":null,"abstract":"<p>This article aims to provide a simple clinical approach to understanding and managing steroid supplementation in young adults and adult patients with classical congenital adrenal hyperplasia secondary to 21-hydroxylase deficiency (21OHD). It aims to overcome the clinical inertia that leads to glucocorticoid excess in these patients, particularly addressing the adult endocrinologist at the transition when they meet the patient with 21OHD with ‘fresh eyes’.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1427-1432"},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730198","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":"Escherichia coli thoracic aortitis in a patient with a transcatheter aortic valve implantation","authors":"Stephanie Drake,&nbsp;Robert Pickles","doi":"10.1111/imj.70149","DOIUrl":"10.1111/imj.70149","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1595-1596"},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730197","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":"Australia and New Zealand consensus statement on the cardiovascular management of patients with chronic lymphocytic leukaemia treated with Bruton's tyrosine kinase inhibitors","authors":"Mary Ann Anderson,&nbsp;Farrukh T. Awan,&nbsp;Leanne Berkahn,&nbsp;Kyle Crassini,&nbsp;Hui-Peng Lee,&nbsp;Paula Marlton,&nbsp;Stephen P. Mulligan,&nbsp;Mark Nolan,&nbsp;Constantine Tam,&nbsp;Aaron L. Sverdlov","doi":"10.1111/imj.70159","DOIUrl":"10.1111/imj.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bruton's tyrosine kinase inhibitors (BTKi) reduce mortality and morbidity in chronic lymphocytic leukaemia (CLL) but have an association with cardiotoxicities, including hypertension, atrial fibrillation (AF), ventricular arrhythmias (VA) and bleeding. There is currently no specific advice for Australian and New Zealand clinicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In this paper, we aim to provide evidence-based recommendations for risk assessment, monitoring and managing cardiovascular (CV) toxicity to optimise patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multidisciplinary roundtable was held on 21 August 2023 to discuss clinical evidence and derive consensus recommendations, which were graded according to class and level of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline CV risk assessment, including patient history, blood pressure (BP), pulse and ECG, is recommended in all patients before starting a BTKi. Management and monitoring requirements should reflect the patient's risk status. A target BP of 140/90 mmHg should be achieved (or 130/80 mmHg in high-risk patients or those with CV disease). In patients with pre-existing AF, closer monitoring is recommended in consultation with cardiology. Oral anticoagulation is generally warranted in patients with a CHA2DS2-VASc score of ≥2 in males or ≥3 in females. BTKi should be withheld for 3 days before and after a minor procedure and 7 days prior to or post a major procedure. Due to the risk of VA and sudden death, BTKi is generally contraindicated in patients with previous VA, severe or uncontrolled heart failure or hypertension. Multidisciplinary care aims to minimise complications and improve treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Further research should be directed at validating CV screening tools and measuring outcomes based on these recommendations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1556-1569"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717860","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":"Reaching new heights in neuroimmunology: a proposed model of care for the Murrumbidgee Local Health District.","authors":"Christina Nitz, Antonia S Carroll, Martin Jude, Jennifer Massey","doi":"10.1111/imj.70166","DOIUrl":"https://doi.org/10.1111/imj.70166","url":null,"abstract":"<p><strong>Background: </strong>Access to specialised medical services in regional and remote areas of Australia faces significant challenges, resulting in delays in diagnosis and treatment, and ultimately poorer patient outcomes. This issue is prevalent across medical disciplines. This article focuses on neuroimmunology services in the Murrumbidgee Local Health District of regional New South Wales, and strategies to enhance comprehensive care for patients with these conditions.</p><p><strong>Aim: </strong>We propose a comprehensive new model of care for individuals affected by neuroimmunological disorders, identifying the needs of key stakeholders and emphasising earlier diagnosis and treatment to improve overall health outcomes. This will be achieved via a novel 'hub-and-spoke' model of metro-regional care, prioritising integration with primary healthcare services.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted to assess existing evidence of national specialist services in regional settings and previously established models of care for delivering medical services in rural and remote Australia. Planning and implementation involved canvassing the needs of general practitioners, specialists, medical trainees, nurses and patient advocates via a comprehensive questionnaire and educational meetings.</p><p><strong>Results and conclusions: </strong>The implementation of specialist neuroimmunology service, partnering metropolitan based specialists and established regional neurologists, is a scalable model of care. Data on referral pathways, time to diagnosis, treatment, and satisfaction are under evaluation to assess improvements qualitatively and quantitatively in clinical outcomes (HREC Ref: 2024/ETH01053). Pathways for referral and monitoring for patients on immunotherapy will be standardised and streamlined. This initiative aims to reduce wait times and time to diagnosis, lower adverse health outcomes and increase patient and clinician satisfaction.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717861","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":"Acceptability of automatic screening for viral hepatitis in an emergency department setting: patient and healthcare worker perspectives","authors":"Tahrima Kayes,&nbsp;Julia Di Girolamo,&nbsp;David S. Prince,&nbsp;Harry Crane,&nbsp;Joseph Pipicella,&nbsp;Melissa Bagatella,&nbsp;Nathan Jones,&nbsp;Paul M. Middleton,&nbsp;Miriam T. Levy","doi":"10.1111/imj.70157","DOIUrl":"10.1111/imj.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Screening for viral hepatitis by automatically ordering hepatitis B and C serology on blood samples already collected from patients presenting to the emergency department (ED) is a relatively novel concept, with modest costs involved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to determine patient and healthcare worker perspectives of automatic hepatitis screening at a large metropolitan hospital in Sydney, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional survey study, patients admitted via ED and ED healthcare workers (HCWs) were invited to participate. The primary outcome was the level of patient and HCW acceptability of an automatic hepatitis screening process. Secondary outcomes were patient and HCW knowledge of viral hepatitis, perceptions and barriers to ED hepatitis screening in the absence of an automatic process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two percent of 273 patients who participated in the survey wished to know their viral hepatitis status, and 82% found automatic hepatitis B and C testing acceptable as part of their ED blood work. HCWs surveyed (48) believed this strategy would increase testing, as most did not routinely interrogate patients for risk factors or other eligibility criteria for hepatitis testing, as the presenting ED complaint was their priority. Even when indications for testing based on current guidelines were present, few (32%) HCWs initiated testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Automatic viral hepatitis testing in ED is supported by the majority of patients and HCWs, and the latter believe it would increase testing rates. Increasing identification of patients with hepatitis, if accompanied by effective linkage to care, could facilitate World Health Organization elimination goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1491-1499"},"PeriodicalIF":1.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690099","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":"Clinico-pathologic characteristics, updated diagnostic approach and value of positron emission tomography for adults with splenomegaly at a large, university hospital","authors":"Huw Richards,&nbsp;Adam Gray,&nbsp;Jawad Saeed,&nbsp;Ethan Troy-Barnes,&nbsp;Stefan Voo,&nbsp;Irfan Kayani,&nbsp;Simon Wan,&nbsp;Michael Brown,&nbsp;Christopher McNamara","doi":"10.1111/imj.70155","DOIUrl":"10.1111/imj.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Splenomegaly is an important finding in numerous conditions. Most reported cohort studies have not included modern diagnostic methods, such as functional imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to determine the utility of newer diagnostic methods and provide an updated approach to splenomegaly by examining recent experience at our centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of adult patients with splenomegaly of unknown cause using imaging reports over 12 months. We used an upper limit of 13 cm and applied a validated height- and sex-adjusted formula (SplenoCalc) where possible. Data were analysed using Fisher's exact test on Graphpad Prism software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Liver pathology was identified in 24%, infectious disease in 19%, haematological disease in 18%, inflammatory disease in 8% and no diagnosis in 28%. Patients who had an 18-F-fluorodeoxyglucose positron emission tomography (FDG PET) scan were significantly more likely to undergo a biopsy (25/38 vs. 23/103, <i>P</i> &lt; 0.0001) and reach a diagnosis (34/38 vs. 84/126, <i>P</i> = 0.007). Eight per cent of assessable patients had a spleen size within normal limits when the SplenoCalc formula was applied. Untreated human immundodeficiency virus (HIV) was identified in 8% of tested patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our cohort, PET scanning, where appropriate, was valuable in identifying sites for biopsy and establishing a cause for splenomegaly, particularly haematological or inflammatory. Routine recording of height and use of the SplenoCalc formula in imaging departments may avoid unnecessary investigation of people with normal sized spleens. Due to the prevalence of untreated HIV in our cohort, we would also recommend HIV testing in all patients with splenomegaly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1516-1523"},"PeriodicalIF":1.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690100","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}