Internal medicine journal
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Internal medicine journal · Dec 2024
ReviewCharting the course: a scoping review on telehealth research trends in Australia.
This review of telehealth research describes the landscape of Australian digital health and telehealth research from 1999 to 2022, focusing on outlining past, present and future trends. A scoping review was conducted using the Joanna Briggs Institute methodology and PRISMA extension for scoping reviews framework, which identified 495 primary research studies of digital or telehealth interventions aimed at improving health outcomes. ⋯ Despite increasing interest in digital and telehealth interventions, the rural and remote populations that stand to benefit the greatest are under-represented in the literature. Future research should focus on these groups, using both emerging and established technologies, and digital and telehealth interventions should be adopted by a wider breadth of health professions.
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Internal medicine journal · Dec 2024
ReviewExcipient induced allergies in oral medications: unravelling the covert threat - a systematic review.
Excipients have been identified as 'inert' substances that often enhance the non-pharmacological aspects of a medication. However, recent clinical evidence elucidates their potential in inducing anaphylaxis and indicates that they are often overlooked as potential allergens in routine clinical practice. The aim of the study was to assimilate published evidence on excipient-induced allergies associated with the use of oral medications and to underline their potential as potent allergens. ⋯ Most patients recovered spontaneously after withdrawal of the offending agent with less than half necessitating additional drug interventions and only a single instance of reported fatality, which cannot be attributed to the excipient alone. Despite being labelled as inert, excipients pose a significant threat for the development of allergic reactions. Simple measures such as increased awareness among patients and healthcare professionals, comprehensive history taking, reviewing medication compositions and improved patient awareness regarding potentially allergenic excipients can aid in avoiding these readily preventable reactions.
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Internal medicine journal · Dec 2024
ReviewPulmonary arterial hypertension: updates and perspective with newer therapies.
Pulmonary arterial hypertension (PAH) is a rare condition for which a remarkable change has been witnessed in the epidemiology, assessment and treatment landscape over the last three decades. Well-established registries from the Western world have not only highlighted the shift in the epidemiology to an older, more comorbid cohort but have also identified markers of prognosis that have been validated as part of risk stratification scores in multiple cohorts. The emphasis on early identification through a systematic assessment pathway and the option of upfront combination therapy with serial risk stratification assessment has laid the foundation for the standard of care and improved prognosis. This review provides an update on the assessment and newer therapies for PAH.
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Internal medicine journal · Dec 2024
ReviewPhenotype of patients with late diagnosis of 22q11 deletion: a review and retrospective study.
Chromosome 22q11.2 deletion syndrome (22q11DS) is the most common microdeletion syndrome, typically presenting in neonates with congenital cardiac anomalies, hypocalcaemia and thymic hypoplasia. Some patients are diagnosed later in adolescence and adulthood, with less known about the clinical phenotype of these patients. ⋯ Chromosome 22q11DS has diverse clinical features and a highly variable phenotype, likely contributing to underdiagnosis and later diagnoses.
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Internal medicine journal · Dec 2024
ReviewThe heart of the matter: a re-iteration of the role of the social determinants of health in addressing health inequity in Central Australia.
The persisting life-expectancy 'gap' between First Nations and non-First Nations Australians is fundamentally driven by the social determinants of health. These include income and social protection, access to adequate housing and food security, among others. These factors are particularly prominent in Central Australia. ⋯ Food insecurity and inadequate social protection manifesting as energy insecurity result in inadequate nutrition and have resulted in a huge burden of diabetes in Central Australia. These factors, combined with social exclusion, racism and the pervasive effect of colonisation, also drive a high rate of alcohol misuse. Only by prioritising equity in these 'social determinants' and emphasising the importance of First Nations leadership in formulating and implementing solutions will health inequity be addressed.