Medical Journal of Australia最新文献

{"title":"Newborn Screening: Equity for Aboriginal and Torres Strait Islander Families in the Context of Emerging Genomics","authors":"Gail Garvey,&nbsp;Kamilaroi,&nbsp;Sarah Norris,&nbsp;Joanne Scarfe,&nbsp;Louise Lyons,&nbsp;Jaadwa","doi":"10.5694/mja2.70272","DOIUrl":"10.5694/mja2.70272","url":null,"abstract":"<p>Australia's newborn bloodspot screening (NBS) program is offered to every newborn. It screens for 34 rare conditions with the potential for hundreds more to be added using genomics. Despite NBS being available in Australia since the 1960s, there is a lack of evidence regarding the participation and experiences of Aboriginal and Torres Strait Islander peoples in NBS. As Australia considers a future where genomics might be used in NBS, there is a critical window of opportunity to understand and prioritise the perspectives, hopes and fears of Aboriginal and Torres Strait Islander peoples regarding the utility of genomics in NBS.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of Cardiovascular Disease Risk Based on the Updated 2023 Guideline-Recommended Australian Cardiovascular Disease Risk Algorithm and Comparison With the 2012 Algorithm: An Observational Study","authors":"Nina Lazarevic,&nbsp;Meghana Bhat,&nbsp;Grace Joshy,&nbsp;Danielle C. Butler,&nbsp;Mark Woodward,&nbsp;Anushka Patel,&nbsp;Rod T. Jackson,&nbsp;Garry Jennings,&nbsp;Rosemary Wyber,&nbsp;Ellie Paige,&nbsp;Emily Banks","doi":"10.5694/mja2.70280","DOIUrl":"10.5694/mja2.70280","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To quantify cardiovascular disease (CVD) risk, and implications for targeting preventive pharmacotherapy, using the 2023 guideline-recommended Australian CVD risk algorithm, and compare this to the previous (2012) algorithm.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Type&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Application and comparison of two risk prediction algorithms.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data from 115,873 people aged 45–74 years without existing CVD, who had a clinical encounter between September 2020 and August 2022, recorded within MedicineInsight, a longitudinal primary care database covering 8% of Australian general practices.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CVD risk distribution and risk categorisation into low-, intermediate- and high-risk groups under the 2023 and 2012 algorithms. Cohen's kappa and Bland–Altman plots were used to assess agreement and concordance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Using the 2023 CVD risk algorithm and revised thresholds, 9.7% of participants were at high CVD risk (≥ 10% 5-year risk or clinically determined high risk); 26.4% were at intermediate CVD risk (5% to &lt; 10% 5-year risk) and 63.9% were at low CVD risk (&lt; 5% 5-year risk). Corresponding 2012 figures for CVD risk were 17.6% high (&gt; 15% 5-year risk or clinically determined high risk), 11.6% intermediate (10%–15% 5-year risk) and 70.8% low (&lt; 10% 5-year risk). Differences in proportions at high risk were largely driven by changes to clinically determined criteria for high risk. Overall, there was moderate-to-substantial agreement (linear-weighted kappa = 0.62) and concordance (Kendall's tau-&lt;i&gt;b&lt;/i&gt; = 0.74) between algorithms.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Proportions estimated at low risk and not routinely recommended pharmacotherapy align with international standards and were similar between guidelines. Although fewer people would be recommended pharmacotherapy due to being high risk under the updated versus previous guidelines, this likely reflects more accurate updated CVD risk estimation for the contemporary Australian population. The 2023 guidelines include a discretionary step (untested in our study) allowing adjustment based on additional factors. To ensure continued reduction of CVD burden across the population, we emphasise the u","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Gone but Often Forgotten: Action Needed to Address Tuberculosis in Aboriginal and Torres Strait Islander Communities","authors":"Nikkita Joshua,&nbsp;Emma L. Smith,&nbsp;Eunice (Cheeky) Love,&nbsp;Christopher P. Lowbridge,&nbsp;Nicole Tukana,&nbsp;Amy Bowden,&nbsp;Megan A. Campbell,&nbsp;Dawn Casey,&nbsp;James Ward","doi":"10.5694/mja2.70277","DOIUrl":"10.5694/mja2.70277","url":null,"abstract":"<p>Tuberculosis is often perceived as a disease of the past in Australia, yet ongoing transmission persists in some jurisdictions and Aboriginal and Torres Strait Islander peoples continue to experience a disproportionate burden. Drawing on lived experience and community perspectives, we highlight challenges navigating tuberculosis care and opportunities to strengthen prevention and care. Achieving tuberculosis elimination requires more than biomedical tools alone. Earlier diagnosis, culturally responsive and community-led approaches, strengthened Aboriginal health workforces and action on social and structural determinants are needed to ensure tuberculosis is addressed rather than forgotten in Australia.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 an Update: The Currency of Clinical Guidelines in Australia—A Cross-Sectional Analysis","authors":"Heath White,&nbsp;Ethan Fernandes,&nbsp;Kristina Peduru-Arachchige,&nbsp;Tari Turner,&nbsp;Steven McGloughlin,&nbsp;Steve McDonald","doi":"10.5694/mja2.70288","DOIUrl":"10.5694/mja2.70288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Long-term and chronic health conditions are associated with a significant burden of disease and economic impact in Australia. Although improving health outcomes requires a multifactorial approach, up-to-date clinical guidelines can optimise healthcare delivery by providing clinicians with evidence-based, actionable recommendations. We aimed to determine the currency and key methodological characteristics of national clinical guidelines published in Australia and focussed on areas of highest prevalence and burden of disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design and Setting</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis by searching PubMed, the Guidelines International Network International Guidelines Library and Australian college and society websites in July 2025 for national clinical guidelines in the five areas of highest prevalence and burden of disease, as defined by the Australian Bureau of Statistics and Australian Institute of Health and Welfare, respectively. Information and metrics relating to time since publication, time since last evidence search and methods and processes (e.g., reporting of clinical questions and Population, Intervention, Comparison, Outcome [PICO] criteria and approval of the guideline by the National Health and Medical Research Council [NHMRC]) were tabulated and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-one guidelines published between 2002 and 2025 were identified, with most relating to diabetes or mental health. The mean times since publication and last search date were 8.6 and 9.8 years, respectively. Most provided details regarding clinical questions (77%), PICO criteria (61%), search strategies (68%) and other methodological considerations, however, fewer than half used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess certainty of evidence or provided details regarding conflicts of interest (48% each). Of the 18 guidelines approved by the NHMRC, five were developed within the previous 5 years and remain approved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For most high-priority clinical conditions in Australia, there are no up-to-date evidence-based guidelines available to support clinical decision-making. Guideline developers and funders should invest more energy and resources into planning for updates and ensuring that methods and processes are optimised to facilitate this, such as considering a living approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Syncytial Virus Disease Burden and Evidence Gaps in Australia Before Immunisation Introduction: A Retrospective Population-Based Study Using 2016-2019 Hospitalisation and 2023 Laboratory Surveillance Data.","authors":"Chisato Imai-Boulter, Jean Li-Kim-Moy, Clayton Chiu, Sanjay Jayasinghe, Kristine Macartney","doi":"10.5694/mja2.70289","DOIUrl":"10.5694/mja2.70289","url":null,"abstract":"<p><p>This study evaluated Australia's national respiratory syncytial virus (RSV) burden and highlighted key data gaps. Hospitalisations (2016-2019) peaked in infants aged < 3 months (4014/100,000) and adults aged ≥ 65 years (122/100,000), nearly doubling over the period. Unspecified causes comprised ≈55% of bronchiolitis hospitalisations in children aged < 24 months. Laboratory notifications (2023) peaked at 6-11 months (7778/100,000). Real-time data integration addressing case-ascertainment and diagnostic testing frequency is essential for accurate burden estimates and future immunisation strategies.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":"e70289"},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forty Years in the Making: Reporting on the Co-Creation of a National Roadmap for Birthing on Country Services for the Best Start to Life","authors":"Res McCalman,&nbsp;Noongar,&nbsp;Anneka J. Bowman,&nbsp;Roianne West,&nbsp;Kalkadunga, Djkunde,&nbsp;Kristie Watego,&nbsp;Bundjalung,&nbsp;Jyai Allen,&nbsp;Claire Clack,&nbsp;Sue Kildea,&nbsp;Sue Kruske,&nbsp;Melanie Briggs,&nbsp;Dharawal, Gumbaynggirr,&nbsp;Cleone Wellington,&nbsp;Wandandian, Cullunghutti, Jerrinja,&nbsp;Rebecca Coddington,&nbsp;Yu Gao,&nbsp;Isabella Garti,&nbsp;Sascha Kowalenko,&nbsp;Gomeroi,&nbsp;Sarah Ireland,&nbsp;Catherine Austin,&nbsp;John D. Boffa,&nbsp;Marah Prior,&nbsp;Arrernte,&nbsp;Kelsie Kahl,&nbsp;Bettina Chaseling,&nbsp;Sarah Khaw,&nbsp;Emily Armstrong,&nbsp;Donna Hartz,&nbsp;Kamilaroi,&nbsp;Yvette Roe,&nbsp;Njikena Jawuru","doi":"10.5694/mja2.70282","DOIUrl":"https://doi.org/10.5694/mja2.70282","url":null,"abstract":"<p>For over 40 years, First Nations communities in Australia have called for community-controlled birthing and maternal–infant health programs that restore First Nations-led, community-controlled birthing systems grounded in cultural authority and sovereignty. ‘Birthing on Country’ services have demonstrated improved First Nations maternal–infant health outcomes, more babies kept out of the child protection system, and reduced health system costs. Restoration and expansion of Birthing on Country services across regions has been inconsistent, and has lacked support for national implementation. In 2022, a large national gathering (‘Best Start to Life’) was co-hosted in Mparntwe (Alice Springs). The focus was Birthing on Country service implementation to address inequities in birthing service provision for First Nations communities. A deliverable of this gathering was the <i>National Roadmap for Birthing on Country Services 2026–2036</i> (the Roadmap). The co-creation of the Roadmap maintained enhanced engagement from a range of stakeholders, to produce inclusive and democratic solutions to perpetual perinatal inequities in health. A two-phased process facilitated national co-creation where national priorities in the reclamation of First Nations Birth Rights were upheld. The Roadmap builds on an evidence-informed and First Nations knowledge-grounded framework, the RISE Implementation Framework. The formation of the Roadmap contrasts against traditional policy creation, transitioning from an evidence-based proposal to a First Nations-endorsed national framework, ready for implementation and government adoption. This novel, national strategic approach to upscale Birthing on Country services has received formal endorsement nationally. The Roadmap provides detailed strategies to address structural reform, and its foundational co-creation process demonstrates that to change practice, researchers must do more than publish evidence in journals for policy change and knowledge translation. The 10-year key deliverables in the Roadmap are a call to action to recognise Birthing on Country as an inherent sovereign right grounded in First Nations Law and governance.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.70282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Osteoporosis Treatment Initiation Following Low-Trauma Fracture: A Population-Based Retrospective Cohort Study in New South Wales, Australia, Using Linked Administrative Health Data","authors":"Mike Lin,&nbsp;Huy Nguyen,&nbsp;Thach Tran,&nbsp;Robert D. Blank,&nbsp;Dana Bliuc,&nbsp;Jacqueline R. Center","doi":"10.5694/mja2.70285","DOIUrl":"https://doi.org/10.5694/mja2.70285","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To characterise osteoporosis medicine prescribing patterns following low-trauma fractures and identify predictors of early treatment initiation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Type&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective population-based cohort study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;New South Wales, Australia, using statewide linked administrative health data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adults aged ≥ 50 years with an incident low-trauma fracture between January 2011 and June 2019.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Primary outcomes were osteoporosis treatment prescribing patterns and timing of initiation after incident fracture over 3 years, categorised as early (within 12 months), late (within 1–3 years) or no initiation. Secondary analyses examined predictors of time to treatment initiation within 12 months using Fine–Gray competing-risk regression.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 132,268 individuals with incident fractures, 63.7% (84,222) were female. Overall, 29,802 (22.5%) initiated osteoporosis medicine, whereas 102,466 (77.5%) remained untreated. Among females (mean [standard deviation] age, 77.7 [10.1] years), 20.1% initiated therapy within 12 months, 7.0% within 1–3 years, and 72.9% remained untreated. Among males (mean [standard deviation] age, 77.2 [10.0] years), the corresponding proportions were 10.8%, 3.7% and 85.6%. After accounting for the competing risk of death, treatment initiation was more likely with non-distal fractures, older age, polypharmacy, prior steroid use, prior dual-energy x-ray absorptiometry and later fracture year, and less likely with greater comorbidity, rural or regional residence and prior hospitalisation for falls. The strongest associations were for hip or vertebral fracture (subdistribution hazard ratio range, 1.90–3.03) and high comorbidity burden (subdistribution hazard ratio range, 0.72–0.75). Almost one in four late initiators had a refracture before starting treatment. Denosumab rapidly replaced oral bisphosphonates as the dominant therapy over time.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;More than three-quarters of individuals remain untreated after fracture, highlighting persistent a","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Growth in Diagnostic CT Knee Imaging in Australia: Implications for Imaging Stewardship","authors":"Hanwen Chen,&nbsp;Rachelle Buchbinder,&nbsp;Sean Docking,&nbsp;Ian A Harris","doi":"10.5694/mja2.70279","DOIUrl":"https://doi.org/10.5694/mja2.70279","url":null,"abstract":"<div>\u0000 \u0000 <p>Computed tomography (CT) of the knee has traditionally had a limited role in routine practice. Recent Medicare data show a rapid increase in CT knee utilisation in Australia, far exceeding growth in other imaging modalities. This divergence is unlikely to reflect clinical need and instead suggests a shift in practice, potentially driven by expansion into non-evidence-based CT-guided procedures. This raises concerns regarding unnecessary radiation exposure, procedure-related harm and escalating costs driven by volume rather than value. The absence of clear differentiation between diagnostic and procedural CT imaging within current Medicare Benefits Schedule item structures limits oversight. Imaging stewardship and policy reform are required to ensure appropriate, evidence-based use.</p>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gabapentinoid Poisoning Presentations to Victorian Emergency Departments: A 15-Year Trend Analysis","authors":"Bishaal Tej Gurung,&nbsp;Amy McNeilage,&nbsp;Angus Skeen,&nbsp;Tina Lam,&nbsp;Joanna F. Dipnall,&nbsp;Jane Hayman,&nbsp;Suzanne Nielsen,&nbsp;Ting Xia","doi":"10.5694/mja2.70275","DOIUrl":"https://doi.org/10.5694/mja2.70275","url":null,"abstract":"<p>This study identified and characterised 1207 emergency department presentations related to gabapentinoid overdose in Victoria from 2009–2010 to 2023–2024. Presentation rates increased substantially since 2009–2010, and about half (49.5%; 597/1207) of all presentations were classified as intentional. Co-ingestants were common, although 36.2% (437/1207) of presentations were reported to involve gabapentinoids alone.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Safety of Concomitant Meningococcal B and National Immunisation Program Vaccines in Infants Aged < 15 Months: A Survey-Based Surveillance Study.","authors":"Thuy Nguyen, Evelyn C S Tay, Michael Dymock, Thomas L Snelling, Lucy Dawes, Julie Marsh, Yue Wu, Alan Leeb, Nicholas Wood, Lucy Deng","doi":"10.5694/mja2.70297","DOIUrl":"10.5694/mja2.70297","url":null,"abstract":"<p><strong>Objective: </strong>To examine short-term safety outcomes following vaccination at 2-, 4-, 6- and 12-month timepoints, comparing infants receiving meningococcal B (MenB) vaccines concomitantly with National Immunisation Program (NIP) vaccines to those receiving vaccines at separate visits.</p><p><strong>Study type: </strong>Observational cohort survey study.</p><p><strong>Setting, participants: </strong>Online surveys via AusVaxSafety were sent 3 days post-immunisation to collect reports of adverse events following immunisation (AEFIs). Infants aged < 15 months were included if, between 1 April 2022 and 31 March 2025, they received NIP and MenB vaccines concomitantly or separately at schedule timepoints, and their carer completed an AusVaxSafety survey.</p><p><strong>Main outcome measures: </strong>Bayesian multinomial logistic regression estimated the risk of reporting any AEFI, medical review and impact on daily activities following each vaccination strategy.</p><p><strong>Results: </strong>Of 45,215 infants receiving NIP and MenB vaccines at the 2-, 4-, 6- and 12-month timepoints (with or without other vaccines), 72% (32,751/45,215) received concomitant vaccination. Excluding those with additional vaccines, 10,959 were included in the analysis. The adjusted model showed the cumulative risk of any AEFI was lower under the concomitant strategy compared with the separate strategy at 2 months (29% [95% credible interval (CrI), 26% to 31%] vs. 35% [95% CrI, 31% to 40%], risk difference -6.7 [95% CrI, -11.5 to -2.2]) and similar at 4 months (45% [95% CrI, 43% to 48%] vs. 47% [95% CrI, 43% to 52%]), 6 months (45% [95% CrI, 42% to 49%] vs. 44% [95% CrI, 38% to 50%]) and 12 months (47% [95% CrI, 45% to 50%] vs. 52% [95% CrI, 48% to 56%]). Medical review within 3 days was lower at 12 months in the concomitant group (4.1% [95% CrI, 3.4% to 5.0%] vs. separate 6.3% [95% CrI, 4.7% to 8.3%], risk difference -2.2 [-4.3 to -0.4]) and comparable across earlier time points (concomitant 2.3%-4.2% vs. separate 3.6%-3.9%). Impact on daily activities was low (concomitant 1.1%-8.5% vs. separate 1.6%-8.3%) with no differences observed between strategies.</p><p><strong>Conclusions: </strong>Separating MenB vaccines from routine NIP vaccines does not reduce, and may increase, the cumulative reaction burden across visits. Findings support concomitant administration.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":"e70297"},"PeriodicalIF":6.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}