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Is semaglutide cost-effective at closing the gap for Aboriginal and Torres Strait Islander Australians with cardiovascular disease and obesity without type 2 diabetes? 西马鲁肽在缩小澳大利亚原住民和托雷斯海峡岛民心血管疾病和肥胖无2型糖尿病的差距方面是否具有成本效益?
IF 1.8 4区 医学
Internal Medicine Journal Pub Date : 2025-07-22 DOI: 10.1111/imj.70160
Satyen Hargovan, Nadine Hunt, Hara Kostakis, Clara K Chow
{"title":"Is semaglutide cost-effective at closing the gap for Aboriginal and Torres Strait Islander Australians with cardiovascular disease and obesity without type 2 diabetes?","authors":"Satyen Hargovan, Nadine Hunt, Hara Kostakis, Clara K Chow","doi":"10.1111/imj.70160","DOIUrl":"https://doi.org/10.1111/imj.70160","url":null,"abstract":"<p><strong>Background: </strong>Aboriginal and Torres Strait Islander Australians experience worse healthcare outcomes due to increased prevalence of cardiovascular disease (CVD). A large proportion of this is preventable if CVD risk factors, such as obesity, are effectively treated. In the SELECT (Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity) trial, the use of semaglutide for patients with CVD and obesity without type 2 diabetes (T2D) significantly reduced the prevalence of CVD.</p><p><strong>Aim: </strong>To determine the cost-benefit to the Australian healthcare system of funding early-access semaglutide for treating Aboriginal and Torres Strait Islander Australians with CVD and obesity without T2D.</p><p><strong>Methods: </strong>A Markov cohort state-transition model was annually cycled for 25 years. The population was Aboriginal and Torres Strait Islander Australians with CVD and obesity without T2D. They received either semaglutide or standard care. Transition probabilities, utilities, costs and discounting were literature-derived. The incremental cost-effectiveness ratio (ICER) was our primary outcome. Disability-adjusted life-years (DALYs) and fatal and non-fatal CVD events prevented were secondary outcomes. Sensitivity analysis for various scenarios was performed.</p><p><strong>Results: </strong>In the estimated 13 650 Aboriginal and Torres Strait Islander Australians with CVD and obesity without T2D, semaglutide was modelled to prevent an additional 929 fatal CVD events, 13 480 non-fatal CVD events and 8628 DALYs over 25 years at an additional cost to the Australian government of $25 956 522/year (<0.2% of annual CVD expenditure). The ICER was $75 206/DALYs.</p><p><strong>Conclusion: </strong>A strategy of early-access funding and use of semaglutide for Aboriginal and Torres Strait Islander Australians with CVD and obesity without T2D may be cost-effective to the Australian healthcare system while closing the gap in healthcare disparities.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690101","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
Association between Full Moon Day overdose-related intensive care unit admissions and hospital mortality: a medical enigma or mere myth? 满月日过量相关的重症监护病房入院与医院死亡率之间的关系:一个医学谜还是纯粹的神话?
IF 1.8 4区 医学
Internal Medicine Journal Pub Date : 2025-07-17 DOI: 10.1111/imj.70154
Ashwin Subramaniam, Ryan Ruiyang Ling, Michael Wu, Paul Secombe, David Pilcher
{"title":"Association between Full Moon Day overdose-related intensive care unit admissions and hospital mortality: a medical enigma or mere myth?","authors":"Ashwin Subramaniam, Ryan Ruiyang Ling, Michael Wu, Paul Secombe, David Pilcher","doi":"10.1111/imj.70154","DOIUrl":"https://doi.org/10.1111/imj.70154","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence on whether Full Moon Day is linked to drug overdoses severe enough to need intensive care unit (ICU) admissions.</p><p><strong>Aims: </strong>To investigate the association between Full Moon Day overdose-related ICU admissions and hospital mortality.</p><p><strong>Methods: </strong>This retrospective multicentre observational study that included data from 172 ICUs across Australia and New Zealand reported to the Australia New Zealand Intensive Care Society Adult Patient Database. We included all adult (≥16 years) patients admitted to an ICU following an overdose between 1 January 2018 and 31 December 2023. The primary outcome was the prevalence of overdose presentations. The secondary outcome was hospital mortality. We used logistic regression models to investigate the association between Full Moon Day overdose and hospital mortality, after adjusting for key confounders. We also analysed this association in a subgroup based on sex.</p><p><strong>Results: </strong>We included 25 577 patients; 4426 (17.3%) were admitted on Full Moon Day. The prevalence of overdose-related ICU admissions for Full Moon Day was similar to those on other lunar days (mean prevalence: 1.4% (standard deviation (SD) 0.6%) vs. 1.4% (SD 0.2%)). The hospital mortality was comparable in both groups of patients (1.3% vs. 1.3%; P = 0.99). There was no association between Full Moon Day overdose-related ICU admission and hospital mortality (adjusted odds ratio = 1.10; 95% confidence interval: 0.77-1.57; P = 0.60). This relationship was consistent in both male and female patients.</p><p><strong>Conclusion: </strong>This large registry-based study found no difference in overdose-related ICU admissions between full moon days and other lunar days, with no association with hospital mortality. This reinforces that the full moon's influence on overdose admissions to the ICU is a myth.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649360","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
A tale of two echoes: ultraportable versus standard echocardiography in patients with left ventricular dysfunction 两个回声的故事:超便携与标准超声心动图在左心室功能障碍患者。
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-17 DOI: 10.1111/imj.70156
Joanne Eng-Frost, Rohanti Ravikulan, Jasmine Chan, Kate Kim, Scott Lorensini, Kate George, Emilie Rasheed, Sam Lehman, Majo Joseph, Carmine G De Pasquale
{"title":"A tale of two echoes: ultraportable versus standard echocardiography in patients with left ventricular dysfunction","authors":"Joanne Eng-Frost,&nbsp;Rohanti Ravikulan,&nbsp;Jasmine Chan,&nbsp;Kate Kim,&nbsp;Scott Lorensini,&nbsp;Kate George,&nbsp;Emilie Rasheed,&nbsp;Sam Lehman,&nbsp;Majo Joseph,&nbsp;Carmine G De Pasquale","doi":"10.1111/imj.70156","DOIUrl":"10.1111/imj.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Handheld echocardiography (HHE) is an emerging tool offering portability and convenience for cardiac imaging. However, its validity in hospitalised patients with left ventricular (LV) dysfunction is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine the concordance of key LV and right ventricular (RV) echocardiographic parameters obtained by HHE and standard echocardiography (SE) in hospitalised patients with LV dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study evaluated hospitalised patients with an echocardiogram during admission demonstrating LV ejection fraction (LVEF) &lt;50%. Key LV and right ventricular (RV) echocardiographic parameters were measured using both standard echocardiography (SE) and HHE. Concordance and differences between both imaging modalities were evaluated using Pearson correlation and paired Student <i>t</i> test, with significance defined as <i>P</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 156 patients were included. No significant differences were observed between SE and HH for LV end-diastolic diameter (5.23 ± 0.87 vs. 5.28 ± 0.72 cm respectively, <i>P</i> = 0.348), LVEF (33.36 ± 9.2 vs. 33.17 ± 9.09, <i>P</i> = 0.521), LV outflow tract velocity time integral (15.83 ± 4.95 vs. 15.80 ± 5.05, <i>P</i> = 0.856) and inferior vena cava diameter (1.96 ± 0.48 vs. 1.92 ± 0.44, <i>P</i> = 0.122). Significant differences were noted for RV basal diameter (3.87 ± 0.63 cm vs. 3.76 ± 0.68 cm, <i>P</i> &lt; 0.001) and tricuspid annular systolic excursion (1.76 ± 0.46 cm vs. 1.83 ± 0.47 cm, <i>P</i> = 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HHE demonstrates strong concordance with SE for LV parameters. Discrepancies were observed for RV parameters, although the clinical implications of these differences are unclear. These findings highlight the evolving role of HHE as a reliable and accessible tool for experienced users, particularly for monitoring hospitalised patients such as those with acute heart failure, where the use of serial SE may enhance clinical decision-making but is limited by logistical barriers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1541-1546"},"PeriodicalIF":1.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649359","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}
引用次数: 0
A retrospective analysis of venous thromboembolism recurrence in isolated distal deep vein thrombosis in Auckland, New Zealand 新西兰奥克兰孤立性远端深静脉血栓形成的静脉血栓栓塞复发回顾性分析
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-12 DOI: 10.1111/imj.70144
Stephen Hong Chun Wong, Dug Yeo Han, Te Apatuoterangi McCrea, Eileen Merriman
{"title":"A retrospective analysis of venous thromboembolism recurrence in isolated distal deep vein thrombosis in Auckland, New Zealand","authors":"Stephen Hong Chun Wong,&nbsp;Dug Yeo Han,&nbsp;Te Apatuoterangi McCrea,&nbsp;Eileen Merriman","doi":"10.1111/imj.70144","DOIUrl":"https://doi.org/10.1111/imj.70144","url":null,"abstract":"<p>Recent registry data suggest that unprovoked isolated distal deep vein thrombosis (UIDDVT) has a higher risk of recurrence, potentially comparable to unprovoked proximal DVT. Our retrospective analysis of prospectively collected data corroborates this finding, with a 5-year incidence rate of 4.45% versus 0.77% per person-years in the UIDDVT and provoked IDDVT groups respectively.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 8","pages":"1382-1386"},"PeriodicalIF":1.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832890","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
Outcomes following lung transplantation for interstitial lung diseases in New Zealand: a retrospective review 新西兰间质性肺疾病肺移植后的预后:回顾性回顾
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-12 DOI: 10.1111/imj.70147
Jeong Suk Oh, James Rance, Eun Ho Choe, Tanya J McWilliams, Mark O'Carroll, Christopher Lewis, Sasiharan Sithamparanathan
{"title":"Outcomes following lung transplantation for interstitial lung diseases in New Zealand: a retrospective review","authors":"Jeong Suk Oh,&nbsp;James Rance,&nbsp;Eun Ho Choe,&nbsp;Tanya J McWilliams,&nbsp;Mark O'Carroll,&nbsp;Christopher Lewis,&nbsp;Sasiharan Sithamparanathan","doi":"10.1111/imj.70147","DOIUrl":"10.1111/imj.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Interstitial lung diseases (ILDs) are a heterogeneous group of diseases that have limited treatment options and can lead to progressive respiratory failures. Lung transplantation offers a therapeutic option for selected patients. There are no New Zealand data published regarding outcomes of those who received lung transplantation for ILDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We assessed survival outcomes after lung transplantation for ILDs in New Zealand, comparing bilateral versus single-lung transplants and size-matched versus mismatched lungs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, single-centre study included ILD patients who underwent lung transplantation from December 2006 to March 2023. Baseline characteristics, survival and post-transplant complications were analysed. Size matching was based on predicted total lung capacity ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourty-four patients underwent lung transplantation for ILDs during this period, with a median recipient age of 54 years old. Median survival was 6.2 years; 30-day and 1-, 3-, 5- and 7-year survival rates were 84%, 80%, 66%, 58% and 49% respectively. Survival did not differ between bilateral and single lung transplants (<i>P</i> = 0.42) or between size matched and mismatched transplants (<i>P</i> = 0.58). Single lung transplants had shorter intensive care unit (ICU) stays and less intra-operative cardiopulmonary bypass use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lung transplantation for ILDs in New Zealand achieves survival outcomes comparable to international centres. No significant survival differences were found between bilateral and single-lung transplants or between sizes matched and mismatched lungs. Single-lung transplantation may offer advantages such as shorter ICU stays and reduced cardiopulmonary bypass use. Careful patient selection, especially in older patients, may improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1532-1540"},"PeriodicalIF":1.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617412","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}
引用次数: 0
Supremacy of the pulse within the medicine of the enlightenment 脉搏在启蒙医学中的至高无上地位。
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-10 DOI: 10.1111/imj.70136
Bruce Short
{"title":"Supremacy of the pulse within the medicine of the enlightenment","authors":"Bruce Short","doi":"10.1111/imj.70136","DOIUrl":"10.1111/imj.70136","url":null,"abstract":"<p>For the minority of the British sick poor, the healing process was conducted as an in-patient in one of the emerging British voluntary hospitals and infirmaries. But those with fevers and contagious diseases were excluded from admission. During the subsequent truncated physical examination, the character of the pulse received especially close attention. The diagnostic regard paid to the pulse assumed the same pre-eminent consideration as bloodletting was within the therapeutic armamentarium. Fever was not considered a symptom within British medicine during the 18th century; rather, it was regarded as a disease <i>sui generis.</i> Indeed, the pulse was regarded as the most reliable guide to the existence of a febrile illness, and variations in the pulse character directed the physician to adopt certain therapeutic modalities. The rapid bounding pulse was a signal of an inflammatory fever, whilst slow low amplitude pulses inferred a typhus-like aetiology. The importance of the pulse to the 18th century practitioner's understanding of sickness, whereby its pre-eminence was gradually replaced by clinical thermometry adopted fitfully during the mid-19th century.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1587-1590"},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600318","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
Is the incidence and burden of cancer increasing among young individuals? An age-related analysis based on Global Burden of Disease Study and Surveillance, Epidemiology and End Results 年轻人的癌症发病率和负担是否在增加?基于全球疾病负担研究和监测、流行病学和最终结果的年龄相关分析。
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-10 DOI: 10.1111/imj.70126
Yijun Cai, Xiaojia Huang, Dong Lin, Dian Gu, Shen Lin, Shaohong Luo, Xiongwei Xu, Xiaoting Huang, Xiuhua Weng
{"title":"Is the incidence and burden of cancer increasing among young individuals? An age-related analysis based on Global Burden of Disease Study and Surveillance, Epidemiology and End Results","authors":"Yijun Cai,&nbsp;Xiaojia Huang,&nbsp;Dong Lin,&nbsp;Dian Gu,&nbsp;Shen Lin,&nbsp;Shaohong Luo,&nbsp;Xiongwei Xu,&nbsp;Xiaoting Huang,&nbsp;Xiuhua Weng","doi":"10.1111/imj.70126","DOIUrl":"10.1111/imj.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer incidence patterns are shifting globally. The overall age profile and secular trends in cancer onset remain inadequately understood, and their impact on the global cancer burden unquantified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to analyse long-term trends of cancer onset age and assess their impact on cancer burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from GBD 2019 and SEER, trends in onset age of 29 cancer types were analysed in the United States and globally over three decades. Early-onset cancers were defined as cases below the 1990 median age; late-onset cancers exceeded this threshold. Mean and median onset age were analysed globally (Socio-Demographic Index (SDI) stratified). Temporal trends were quantified using average annual percentage change. Age changes related to population structures were evaluated by fixing cancer incidence in 1990. Changes in cancer burden by age were evaluated using disability-adjusted life years for younger and older age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the United States, most cancers showed increasing onset ages. Globally, prostate cancer had a decreasing mean age, while nasopharynx, uterine and prostate cancers displayed declining median ages. The global cancer burden significantly increased for the older age group, surpassing the increase in the younger age group. A similar pattern was observed across SDI, except for low SDI. Notably, early-onset cancers exhibited a trend towards earlier onset in low SDI regions, while the burden remained greater in high SDI areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most cancer types showed an increasing onset age in the United States and globally. Despite population aging, certain cancers had a younger onset age. Policymakers and healthcare systems should be aware of these trends and take appropriate action. The young generation should also stay vigilant about cancers with a younger onset age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 9","pages":"1463-1473"},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600317","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}
引用次数: 0
Uncovering unmet social needs in oncology patients 揭示肿瘤患者未满足的社会需求
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-09 DOI: 10.1111/imj.70146
Linh Van, Mark A Boyd, Kate E Neadley, Christopher Hocking
{"title":"Uncovering unmet social needs in oncology patients","authors":"Linh Van,&nbsp;Mark A Boyd,&nbsp;Kate E Neadley,&nbsp;Christopher Hocking","doi":"10.1111/imj.70146","DOIUrl":"https://doi.org/10.1111/imj.70146","url":null,"abstract":"<p>Social determinants of health are upstream causes of unmet social needs, contributing to disparities in health and wellbeing outcomes. This study examines the unmet social needs of cancer patients living in a disadvantaged Australian region, revealing that 72% experienced at least one unmet need. This study highlights the complex and multifactorial social challenges facing a disadvantaged population undergoing cancer treatment.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 8","pages":"1377-1381"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832616","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
Prevalence of inpatient blood pressure elevations in Australian hospitalised patients and analysis of associated factors. 澳大利亚住院患者血压升高患病率及相关因素分析
IF 1.8 4区 医学
Internal Medicine Journal Pub Date : 2025-07-09 DOI: 10.1111/imj.70145
Jin Nuo Joan Tsang, Richard Woodman, Arduino A Mangoni
{"title":"Prevalence of inpatient blood pressure elevations in Australian hospitalised patients and analysis of associated factors.","authors":"Jin Nuo Joan Tsang, Richard Woodman, Arduino A Mangoni","doi":"10.1111/imj.70145","DOIUrl":"https://doi.org/10.1111/imj.70145","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a significant cardiovascular risk factor. While community hypertension is well studied, inpatient hypertension remains poorly understood with limited epidemiological data in Australian cohorts. We therefore investigated the prevalence and factors associated with inpatient systolic blood pressure (SBP) elevations, defined as SBP ≥140 mmHg using Australian data.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on non-cardiac inpatients aged ≥65 admitted to general medical wards at Flinders Medical Centre, Adelaide (January-April in 2022-2024). Blood pressure recordings during hospital stay were extracted from electronic medical records. The primary endpoint was ≥10 SBP readings ≥140 mmHg, with secondary endpoints being at least one, two or three readings ≥140 mmHg.</p><p><strong>Results: </strong>Among 753 eligible patients, 94.2% had at least one, 89.4% two, 85.7% three and 65.2% 10 SBP readings ≥140 mmHg. Independent factors positively associated with ≥10 elevations included age (years) (OR = 1.022, CI 1.00-1.04, P = 0.033), number of comorbidities (OR = 1.203, CI 1.06-1.35, P = 0.0026), length of stay (days) (OR = 1.041, CI 1.02-1.07, P = 0.002), antihypertensive use prior to admission (OR = 1.95, CI 1.26-3.02, P = 0.003) and use of calcium channel blockers (OR = 2.55, 1.53-4.25, P < 0.001). Whereas beta-blocker use (OR 0.593, CI 0.38-0.92, P = 0.020), history of coronary artery disease (OR = 0.59, CI 0.38-0.90, P = 0.015), chronic obstructive lung disease (OR = 0.46, CI 0.39-0.69, P < 0.001) and heart failure (OR = 0.43, CI 0.27-0.7, P < 0.001) were negatively associated.</p><p><strong>Conclusions: </strong>This study provides first evidence of the epidemiology of inpatient SBP elevations in Australian inpatients and the associated factors. Further research should determine the clinical significance of these elevations and the impact of blood-pressure-lowering strategies in hospital settings.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591190","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
Enablers and barriers to conducting research in general medicine advanced training 开展全科医学高级培训研究的推动因素和障碍
IF 1.5 4区 医学
Internal Medicine Journal Pub Date : 2025-07-08 DOI: 10.1111/imj.70143
Sylvia Ye, Rattanak Visal Hean, Mandy Chen, Elizabeth Potter, Ian Scott, Ar Kar Aung
{"title":"Enablers and barriers to conducting research in general medicine advanced training","authors":"Sylvia Ye,&nbsp;Rattanak Visal Hean,&nbsp;Mandy Chen,&nbsp;Elizabeth Potter,&nbsp;Ian Scott,&nbsp;Ar Kar Aung","doi":"10.1111/imj.70143","DOIUrl":"https://doi.org/10.1111/imj.70143","url":null,"abstract":"<p>Trainee research is an obligatory part of specialist training. An anonymous survey involving 83 general and acute medicine advanced trainee respondents found insufficient time, knowledge and access to assistance in statistics, data management and ethics as major barriers to conducting research. Trainees desired directories of research projects, supervisors and resources developed, with access to examples of published research by trainees.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 8","pages":"1387-1391"},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832792","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
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